Thursday, January 24, 2019

Spinal Fractures Can Be Terribly Painful. A Common Treatment Isn’t Helping. - The New York Times

Scientists warned osteoporosis patients on Thursday to avoid two common procedures used to shore up painful fractures in crumbling spines.

The treatments, which involve injecting bone cement into broken vertebrae, relieve pain no better than a placebo does, according to an expert task force convened by the American Society for Bone and Mineral Research.

The task force noted that the pain goes away or diminishes within six weeks without the procedure. Patients should take painkillers instead, the experts said, and maybe try back braces and physical therapy.

More ...

Sunday, January 20, 2019

Repeated pain makes men more sensitive — but not women | CBC Radio

Dr. Loren Martin and his colleagues were actually investigating another question when they discovered this surprising result. They were measuring how multiple sources of pain changed pain perception.

In experiments, in mice they used a heat probe that created an mild level of heat on the mouse's feet. Then they gave the mice a dose of vinegar to upset their stomachs. The mice, unsurprisingly, didn't like it.

The suprise came when they they repeated the experiment. The male mice showed more stress when brought back to the location of the experiment, and had stronger responses to the heat stimuli - they were more sensitivity to the pain. The female mice showed no extra stress or sensitivity.

Researchers shone a mild heat probe at the mice's feet to induce a slight pain in the experiment. (Sana Khan)
They then ran a similar experiment on humans.

They used the same combination of stimuli - heat on the forearm, and an uncomfortably tight blood pressure cuff over the bicep. They left the cuff on for about 20 minutes and had the participants do arm exercises to increase the pain.

The participants came back the next day and were sent to the same environment where they wore the blood pressure cuff to repeat the heat probe experiment. This time, the men reported feeling more pain from the heat probe, while nothing changed for the women. It was the same sex difference that they'd seen in the mice.

More ...

Monday, January 14, 2019

Managing Children’s Pain After Surgery - The New York Times

Pain control in infants and children has come a long way over the past few decades. Experts know how to provide appropriate anesthesia when children need surgery and understand the ways that even very young children express distress when they're hurting afterward. There is a lot of evidence about reducing the pain and anxiety that can accompany immunizations and blood draws, and there is increasing expertise about helping children who struggle with chronic pain.

But today's parents may be shocked to learn that was not always the case. As recently as the early 1980s, the pain of children and infants was thought to be different from that of adults and was sometimes treated differently, or sometimes not treated at all.

Change doesn't always come easily in medicine, so there's a certain onus on parents to make sure that their children get state-of-the-art pain management around procedures, large and small. That means preparation before any planned surgery, ideally with a child life specialist, and it means careful attention to the child's pain afterward, with parents well backed up by medical specialists.

More ...