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July 2010 Briefing - Pain Management

Here are what the editors at HealthDay consider to be the most important developments in Pain Management for July 2010. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Transforaminal Steroid Shot Benefits Lumbar Radicular Pain

FRIDAY, July 30 (HealthDay News) -- Transforaminal injection of steroids appears to be a viable alternative to surgery for some patients with lumbar radicular pain caused by disc herniation, according to a study published online July 30 in Pain Medicine.

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Exercise Adherence Helps Osteoarthritis Patients

FRIDAY, July 30 (HealthDay News) -- Greater adherence to home exercise and more physical activity in general appear to enhance the long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip and/or knee, according to research published in the August issue of Arthritis Care & Research.

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Continuous Morphine Plus Injection Preemptive Pain Option

FRIDAY, July 30 (HealthDay News) -- Preemptive analgesia using continuous subcutaneous morphine combined with a single intrathecal injection of morphine (SI) in patients who undergo posterior lumbar interbody fusion provides a favorable analgesic effect and compares favorably with continuous subcutaneous morphine alone (SC), according to a study published in the July issue of the Journal of Spinal Disorders & Techniques.

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Specialties See Modest Compensation Increases in '09

FRIDAY, July 30 (HealthDay News) -- Most medical specialties saw modest compensation increases in 2009, but many provider organizations are still operating at a substantial loss, according to the findings of the American Medical Group Association's (AMGA) 2010 Medical Group Compensation and Financial Survey.

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Nurses Perceive Barriers in Pain Management

THURSDAY, July 29 (HealthDay News) -- Nurses' perceptions of barriers preventing optimal pain management in older adults in acute medical units, as well as their perceived adoption of specific evidence-based guidelines, are not always consistent with actual practice, according to a study published in the August issue of Applied Nursing Research.

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Predictors for Long-Term Back Pain and Disability Evaluated

WEDNESDAY, July 28 (HealthDay News) -- For patients who miss work with low back pain (LBP), persistent disability and pain one year after treatment are associated with baseline pain intensity and degree of disability, diffuse tenderness, health anxiety and fear avoidance, little or moderate exercise, and having made a compensation claim, according to a study in the August issue of The Spine Journal.

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FDA Panels Vote Against Plan to Reduce Opioid Abuse

MONDAY, July 26 (HealthDay News) -- On July 23, two U.S. Food and Drug Administration advisory panels voted against the FDA's plan for reducing abuse of long-acting and extended-release opioid drugs.

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Back Pain Diagnostic Blocks Delay Pain Relief, Add Cost

MONDAY, July 26 (HealthDay News) -- Performing one or more temporary diagnostic nerve blocks to establish arthritis as the cause of back pain before treatment with radiofrequency denervation results in unnecessary tests, delayed pain relief, and added cost, according to a study in the August issue of Anesthesiology.

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Approaches for ACL Injuries Linked to Similar Outcomes

WEDNESDAY, July 21 (HealthDay News) -- Among young, physically active adults with acute anterior cruciate ligament (ACL) tears, rehabilitation with optional delayed ligament reconstruction is associated with similar outcomes as rehabilitation plus early reconstruction, and it reduces the rate of reconstruction, according to research published in the July 22 issue of the New England Journal of Medicine.

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Admissions for Prescription Pain Reliever Abuse Rising

FRIDAY, July 16 (HealthDay News) -- Substance abuse admissions involving prescription pain reliever abuse increased from 2.2 to 9.8 percent between 1998 and 2008 in those aged 12 and older, according to a recent study by the Substance Abuse and Mental Health Services Administration (SAMHSA).

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High Acupuncture Expectations Not Linked to Outcomes

FRIDAY, July 16 (HealthDay News) -- In patients with chronic low back pain, having a positive predisposition toward acupuncture doesn't predict better outcomes, according to research published in the July 1 issue of Spine.

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Pain and Depression Dim Work Expectations After Whiplash

FRIDAY, July 16 (HealthDay News) -- Among people who suffer whiplash-associated disorder (WAD) resulting from a car accident, those in the most pain and those with depression symptoms appear to have the lowest expectations of returning to work, according to a study in the July 1 issue of Spine.

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Telecare Management Lowers Pain, Depression in Cancer

TUESDAY, July 13 (HealthDay News) -- A centralized telephone-based care management approach combined with automated symptom monitoring can improve pain and depression in patients with cancer, according to a study published in the July 14 issue of the Journal of the American Medical Association.

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High Levels of Satisfaction Seen for Lumbar Fusion in Elderly

MONDAY, July 12 (HealthDay News) -- Elderly patients can benefit from lumbar spinal fusion in terms of reduced leg and back pain, and age alone is not a contraindication, according to a study in the July 1 issue of Spine.

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FDA: Off-Label Use of Malaria Drug Tied to Serious Effects

FRIDAY, July 9 (HealthDay News) -- In response to continued reports of serious side effects in patients using quinine sulfate (Qualaquin) off-label for the treatment or prevention of nocturnal leg cramps, the U.S. Food and Drug Administration has approved a Risk Evaluation and Mitigation Strategy (REMS) to educate practitioners and patients about the potential for serious side effects associated with such unapproved uses.

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Risk of GI Bleeding Varies by NSAID Type, Dosage

WEDNESDAY, June 2 (HealthDay News) -- The risk of gastrointestinal (GI) complications due to nonsteroidal anti-inflammatory drug (NSAID) use varies by the specific drug used and by dosage, and those with a slow-release formulation or long half-life are associated with a greater risk, according to research published in the June issue of Arthritis & Rheumatism.

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Poor Health Literacy Not Major Factor in LBP Disability

THURSDAY, July 8 (HealthDay News) -- Beliefs about chronic low back pain (CLBP), as well as behaviors related to fear of pain, have more effect on disability than pain intensity or LBP health literacy, according to research published in the July issue of Pain.

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Glucosamine Similar to Placebo in Treating Back Pain

TUESDAY, July 6 (HealthDay News) -- Compared with placebo, treatment with glucosamine is not associated with reductions in pain-related disability in people with chronic low back pain and degenerative lumbar osteoarthritis, according to a study in the July 7 issue of the Journal of the American Medical Association.

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Fifth of Medicare Patients With Spinal Stenosis Have Surgery

FRIDAY, July 2 (HealthDay News) -- About one out of five Medicare patients with lumbar spinal stenosis (LSS) receives surgery within three years of diagnosis, and there appears to be an association between the type of surgery provided and the point after diagnosis when surgery is carried out, according to research published in the July issue of The Spine Journal.

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Report Addresses Physician Financial Conflicts in Care

THURSDAY, July 1 (HealthDay News) -- In a new report, the Association of American Medical Colleges (AAMC) urges U.S. teaching hospitals to establish policies that ensure financial relationships between physicians and industry do not result in conflicts of interest that influence patient care.

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