Cancer pain patients do not successfully handle opioids.

Objective: To evaluate patterns of opioid handling as well as their associated -variables.

Design: A transversal study.

Setting: Institutional care.

Consistency of inconsistency in long-COVID-19 pain symptoms persistency: A systematic review and meta-analysis.

Introduction: Individuals recovering from acute COVID-19 episodes may continue to suffer from various ongoing symptoms, collectively referred to as Long-COVID. Long-term pain symptoms are amongst the most common and clinically significant symptoms to be reported for this post-COVID-19 syndrome.

Objectives: This systematic review and meta-analysis aimed to evaluate the proportions of persisting pain symptoms experienced by individuals past the acute phase of COVID-19 and to identify their associated functional consequences and inflammatory correlates.

Long-term safety of spinal cord stimulation systems in a prospective, global registry of patients with chronic pain.

The availability of long-term (>2 years) safety outcomes of spinal cord stimulation (SCS) remains limited. We evaluated safety in a global SCS registry for chronic pain. Participants were prospectively enrolled globally at 79 implanting centers and followed out to 3 years after device implantation.

Short- and long-term effects of conventional spinal cord stimulation on chronic pain and health perceptions: A longitudinal controlled trial.

Background: The effectiveness and long-term outcomes of spinal cord stimulation (SCS) are not fully established, especially considering that data from patients who withdrew from the trial are rarely analysed, which may lead to overestimation of SCS efficacy. We evaluated short- and long-term effects of SCS on chronic pain and perceived health, beyond natural variability in these outcomes.

Methods: In a prospective design, 176 chronic pain patients referred to SCS were evaluated five times (baseline; retest ~6 weeks later; post-SCS trial; 8 and 28 weeks post-permanent implantation).

Attitudes Toward the Use of Medical Cannabis and the Perceived Efficacy, Side-effects and Risks: A Survey of Patients, Nurses and Physicians.

Gaps between physician and patient perceptions may lead to misunderstandings and mismanage of treatment. There are sparse data about the differences in opinions toward medical cannabis (MC) between patients and health professionals. The aim of this study was to examine the attitudes toward MC, its perceived efficacy, side effects and risk of dependency, among patients, nurses and physicians.

The effects of TENS, interferential stimulation, and combined interferential stimulation and pulsed ultrasound on patients with disc herniation-induced radicular pain.

Background: Electrotherapy is part of a physician's toolbox for treating various musculoskeletal conditions, including radicular pain, but the preferred modality is yet unclear.

Objective: To compare the short-term efficacy of three electrotherapeutic modalities in relieving lumbar disc herniation (LDH)-induced radicular pain.

Methods: Fourteen patients with LDH-induced radicular pain attended a single session of electrotherapy, which included four 10-min consecutive treatments: transcutaneous electrical nerve stimulation (TENS), interferential (IF) stimulation, a combined treatment with pulsed ultrasound and IF current (CTPI), and a sham control.

Medical cannabis treatment for chronic pain: Outcomes and prediction of response.

Background: Although studied in a few randomized controlled trials, the efficacy of medical cannabis (MC) for chronic pain remains controversial. Using an alternative approach, this multicentre, questionnaire-based prospective cohort was aimed to assess the long-term effects of MC on chronic pain of various aetiologies and to identify predictors for MC treatment success.

Methods: Patients with chronic pain, licensed to use MC in Israel, reported weekly average pain intensity (primary outcome) and related symptoms before and at 1, 3, 6, 9 and 12 months following MC treatment initiation.

Depression level, not pain severity, is associated with smoked medical marijuana dosage among chronic pain patients.

Background: The use of medical marijuana (MM) for the treatment of chronic pain is rapidly growing in the United States and Europe; however there is concern regarding the specificity of its therapeutic effects and the motivation underlying its use. While research indicates that among chronic pain prescribed opioids, depression has been associated with increased opioid dosage (regardless of pain levels), the extent to which depression and pain each contribute to MM dose among chronic pain patients is yet unknown.

Methods: This cross-sectional study included 209 chronic pain patients prescribed smoked MM, in flower or other plant form, with no concurrent opioid treatment.

Enhanced pain modulation capacity among individuals with borderline personality disorder: A possible mechanism underlying their hypoalgesia.

Background: Ample evidence suggests that individuals with borderline personality disorder (BPD) exhibit hyposensitivity to pain. Since the underlying mechanism of the pain hyposensitivity is unknown, we tested here for the first time whether this hyposensitivity is pain specific or exists also for innocuous sensation, and whether it is associated with enhanced descending pain modulation capabilities.

Methods: Participants were 55 women; 22 patients with BPD and 33 matched healthy controls.

[MEDICAL MARIJUANA DEPENDENCE AMONG CHRONIC PAIN PATIENTS SUFFERING FROM DEPRESSION AND ANXIETY].

Introduction: In recent years, medical marijuana (MM) is increasingly being used for the treatment of chronic pain. Depression and anxiety have been identified as risk factors for the problematic use of prescription opioids, yet their contribution to developing MM dependence hasn't been explored up to date. In this study we explored the association between depression and anxiety severity and the risk for cannabis dependence among chronic pain patients prescribed MM.

Efficiency of Tissue Penetration by Currents Induced by 3 Electrotherapeutic Techniques: A Comparative Study Using a Novel Deep-Tissue Measuring Technique.

Background: Electrotherapy provides a wide range of treatment alternatives for musculoskeletal pathologies. However, for the electrical stimulation to exert a significant therapeutic effect, the induced current must often penetrate deep inside the target tissue.

Objective: The objective was to systematically compare the penetration efficiency of 3 electrotherapeutic stimulation modalities: transcutaneous electrical nerve stimulation (TENS), interferential (IF) stimulation, and combined therapy with pulsed ultrasound and IF current (CTPI).

Personal experience and attitudes of pain medicine specialists in Israel regarding the medical use of cannabis for chronic pain.

Introduction: The scientific study of the role of cannabis in pain medicine still lags far behind the growing use driven by public approval. Accumulated clinical experience is therefore an important source of knowledge. However, no study to date has targeted physicians who actually use cannabis in their daily practice.

The association between severity of depression and prescription opioid misuse among chronic pain patients with and without anxiety: A cross-sectional study.

Background: In light of the increased rates of Prescription Opioid (PO) misuse and associated mortality in several developed countries in recent years, efforts have been made to identify populations who may be at increased risk for misuse of POs. Though the association between depression and PO misuse among pain patients is well documented, little is known regarding the effects of severity of depression on rates of misuse. In this study we explored rates of PO misuse among chronic pain patients screening positive for depression according to level of severity.

Pain Perception and Body Awareness Among Individuals With Borderline Personality Disorder.

Studies indicate that individuals with borderline personality disorder (BPD) often demonstrate attenuated pain perception, termed hypoalgesia. This study examines the hypothesis that body awareness moderates the association between BPD and pain perception. Participants consisted of 46 women diagnosed with BPD and 47 healthy controls.

Misuse of prescription opioids among chronic pain patients suffering from anxiety: A cross-sectional analysis.

Objective: In the past two decades, chronic pain has been increasingly treated with prescription opioids, particularly in developed countries. This has drawn public concern of possible risks associated with the potential misuse of prescriptions opioids. Previous research has indicated that this may be particularly true among individuals suffering from co-occurring psychiatric disorders.

Depression and anxiety among chronic pain patients receiving prescription opioids and medical marijuana.

Background: High rates of depression and anxiety have been consistently reported among patients suffering from chronic pain. Prescription opioids are one of the most common modalities for pharmacological treatment of pain, however in recent years medical marijuana(MM) has been increasingly used for pain control in the US and in several countries worldwide. The aim of this study was to compare levels of depression and anxiety among pain patients receiving prescription opioids and MM.

Problematic Use of Prescription Opioids and Medicinal Cannabis Among Patients Suffering from Chronic Pain.

Objective: To assess prevalence rates and correlates of problematic use of prescription opioids and medicinal cannabis (MC) among patients receiving treatment for chronic pain.

Design: Cross-sectional study.

Setting: Two leading pain clinics in Israel.

Magnetic resonance-guided focused ultrasound treatment of facet joint pain: summary of preclinical phase.

Study Design: A phantom experiment, two thermocouple experiments, three in vivo pig experiments, and a simulated treatment on a healthy human volunteer were conducted to test the feasibility, safety, and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for treating facet joint pain.

Objective: The goal of the current study was to develop a novel method for accurate and safe noninvasive facet joint ablation using MRgFUS.

Summary Of Background Data: Facet joints are a common source of chronic back pain.

Differentiating between heat pain intensities: the combined effect of multiple autonomic parameters.

Although it is well known that pain induces changes in autonomic parameters, the extent to which these changes correlate with the experience of pain is under debate. The aim of the present study was to compare a combination of multiple autonomic parameters and each parameter alone in their ability to differentiate among 4 categories of pain intensity. Tonic heat stimuli (1minute) were individually adjusted to induce no pain, low, medium, and high pain in 45 healthy volunteers.

Prevalence of fibromyalgia syndrome in patients referred to a tertiary pain clinic.

Background: Fibromyalgia syndrome (FMS), the prototypical central pain augmentation syndrome, is characterized by widespread pain and tenderness. Although patients referred to tertiary care pain clinics are recognized as suffering from chronic pain, they are generally considered to have pain attributable to discrete peripheral, nociceptive, or neuropathic etiology.The purpose of the current study was to assess the prevalence of FMS among consecutive patients referred to a tertiary pain clinic and to evaluate the contribution of central pain to the clinical impact upon such patients.

Topical ophthalmic amethocaine alleviates trigeminal neuralgia pain.

Background: Trigeminal neuralgia (TGN) is a challenging pain syndrome.

Aim: To test the effectiveness of local instillation of ophthalmic solution of amethocaine in relieving the pain of TGN.

Methods: We performed an open-label prospective study in 40 consecutive currently treated patients suffering from TGN with a reported visual analog scale (VAS) >8 (severe pain).

Neuromodulation in the management of pain from brachial plexus injury.

We are presenting a paper on the effectiveness of spinal cord stimulation (SCS) in 2 patients suffering pain from brachial plexus injury (BPI). After a traumatic brachial plexus lesion about 80% of patients develop pain in the deafferentated arm. This pain is considered very resistant to many forms of therapy.

Terminating migraine with allodynia and ongoing central sensitization using parenteral administration of COX1/COX2 inhibitors.

Objective: To determine whether delayed infusion of COX1/COX2 inhibitors (ketorolac, indomethacin) will stop migraine in allodynic patients, and suppress ongoing sensitization in central trigeminovascular neurons in the rat.

Background: The majority of migraineurs seeking secondary or tertiary medical care develop cutaneous allodynia during the course of migraine, a sensory abnormality mediated by sensitization of central trigeminovascular neurons in the spinal trigeminal nucleus. Triptan therapy can render allodynic migraineurs pain free within a narrow window of time (20 to 120 minutes) that opens with the onset of pain and closes with the establishment of central sensitization.

2003 Wolff Award: Possible parasympathetic contributions to peripheral and central sensitization during migraine.

Background: Neurologic signs of increased parasympathetic outflow to the head often accompany migraine attacks. Because increased parasympathetic outflow to the cranial cavity induces vasodilation of cerebral and meningeal blood vessels, it can enhance plasma protein extravasation and the release of proinflammatory mediators that activate perivascular nociceptors. We recently showed that activation of intracranial perivascular nociceptors induces peripheral and central sensitization along the trigeminovascular pathway and proposed that these sensitizations mediate the intracranial hypersensitivity and the cutaneous allodynia of migraine.