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How to Handle Severe Pain

Posted on 05.27.15 |

From Wikihow.com

Handling severe pain can be distressful and difficult. Sometimes pain can happen suddenly and unexpectedly, and sometimes the pain comes from an existing condition or illness. Either way, there are ways to help you handle severe and excruciating pain. Stay focused on controlling your pain and find the techniques that work best for you.

Stay calm. Experiencing pain is distressful, especially if the source of the pain is unknown. Feeling anxious, panicky, and fearful can actually make the pain worse. Shallow breathing can lead to hyperventilation, impair the ability of getting oxygen into the blood, and lead to more pain, like chest and muscle pain.

Try not to focus on the pain. Focusing your thoughts and energy on the pain you are feeling can actually make it worse. Try to relax and focus on other things. For example, think about the next steps you need to take to address the problem causing the pain.

To read full article: CLICK HERE

Flowonix Medical Inc. Announces First Implants of Prometra® II

Posted on 05.12.15 |

May 6, 2015 2:33 PM

MOUNT OLIVE, N.J., May 6, 2015 /PRNewswire/ — Flowonix Medical, Inc., announced today that the first implants of its Prometra® II intrathecal infusion pump took place on May 5, 2015 at St. Francis Hospital in Charleston, West Virginia. A Prometra II pump was implanted in three patients: a 56-year-old man, a 68-year-old woman, and a 53-year-old man for chronic conditions, including neck pain and lower back pain. The procedures were all performed by Dr. Timothy Deer and Dr. Christopher Kim. The patients were reported to be doing well, and Drs. Deer and Kim considered the surgeries successful.

“These first implants of the Prometra® II infusion system were successful, without any complications,” stated Dr. Deer. “The Prometra devices from Flowonix are very accurate intrathecal infusion systems, which are critical to improved patient safety, and Prometra II offers a proprietary flow-activated safety valve or FAV™ technology, designed to shut off drug flow to the patient if a high flow rate should ever occur during magnetic resonance imaging. Prometra II gives our patients added safety, in case an MRI is ever needed.”

Magnetic resonance imaging (MRI) is an imaging procedure that may be contraindicated for patients with certain implanted devices because strong electromagnetic energy may interfere with device function.

“The patients are doing well and will get improved pain relief,” added Dr. Kim. “It is a major advantage of the Prometra II system that it has such a long service life. This not only benefits our patients, but also the healthcare system. A recent retrospective study from the Cleveland Clinic found this type of drug-delivery system to be cost effective,1 even when looking at older and less efficient devices. With the state-of-the-art Prometra II pump, our patients can expect many years of accurate drug delivery at costs that are likely much lower than other forms of pain therapy.”

The study by Bolash and colleagues found the median device longevity of these older infusion systems to be 5.4 years with a median cost per day of $10.46. The newer Prometra devices have a ten-year service life, which is nearly double that of older systems.

“Prometra II borrows from the outstanding technology of its predecessor, Prometra,” added Steve Adler, President and CEO of Flowonix. “Like its predecessor, Prometra II is a long-lasting device with the most accurate drug delivery available today in any implantable intrathecal infusion system, but it also offers FAV™ technology for enhanced patient safety. These first implants of Prometra II in the United States mark another major milestone for Flowonix. All of us at Flowonix extend our congratulations to Drs. Deer and Kim on the successful implants of Prometra II and we wish the very best to their patients.”

About FlowonixFlowonix Medical Inc. (www.flowonix.com), headquartered in Mt. Olive, NJ, is dedicated to working with healthcare professionals to help ease suffering associated with chronic pain and allow patients to reclaim their lives through innovation and therapy advancements. The strategic business goal of Flowonix Medical Inc. is to become the leading implantable drug delivery company in the world. Founded in 2005, Flowonix Medical Inc. received approval to conduct its first clinical trial in 2007 on the Prometra programmable implantable pump. The company received approval by the FDA to market the Prometra in 2012. Flowonix Medical Inc. has been granted multiple patents, and is focused on working closely with physicians to rapidly improve the capabilities of implantable drug delivery and management systems.

For more information, please visit http://www.flowonix.com.

Head Injury Causing Chronic Pain?

Posted on 05.12.15 |

Head injuries are among the more serious injuries you can sustain in an accident or physical episode. They take quite a bit of time to heal, can affect all areas of the body – depending on the injury in question – and may result in chronic pain, depending on the extent of the injury. Dealing with a head injury of any type takes patience and a willingness to endure medical intervention on many levels, including frequent check-ups with a doctor, physical therapy to overcome chronic pain and sometimes even a rearrangement of lifestyle choices to accommodate the injury and the result of it.

Working closely with your family physician is a start to this process. This is the person that can guide you through the healing process and suggest the proper medications and healing techniques that you can utilize until you get well. This is also the person to whom you can go for advice as you deal with the repercussions of the head injury.

Additionally, get as engaged in any physical therapy you are undergoing as well, whether it’s prescribed by your doctor or self-induced. The harder you work to overcome the effects of a traumatic injury, the sooner you will see results and the more encouraged you will be about the process overall.

However, one of the most important things about dealing with head injuries is facing the chronic pain that often accompanies them. Because the brain controls the rest of the body, you may be facing both physical and emotional pain elsewhere that you hadn’t experienced before. For instance, many head injury patients tend to have chronic heads, back pain and other forms of chronic pain. Nerve damage can also occur from a head injury, depending on where the injury occurred and what other parts of the body were affected as a result. In fact, the more areas of your body injured and impacted, the more likely it is that you will face lasting and chronic pain.

Because this pain is lasting, these patients tend to get frustrated and set themselves back emotionally in the healing process as a result. Understanding where this pain is coming from and learning how to deal with it on a regular basis can facilitate a healthier attitude about dealing with chronic pain and the time it may take for your head injury to heal properly. Depression is also a common side effect of chronic pain, so it is important to be aware of what the signs of depression are and seek medical attention if you feel down or blue for more than a few days. There are a number of medications on the market that can help you to function, even if temporarily, as you deal with a new life that includes chronic pain.

Relaxation techniques are also generally helpful for dealing with chronic pain, whether this pain was caused by a head injury or not. Massage therapy, acupuncture, chiropractic care and restorative exercises are all great ways to keep the body moving after a head injury. However, it is always advisable to talk over these plans with your doctor before embarking on a new plan in order to ensure that it is safe for you to do. If the doctor gives you the green light, then choose an activity that both moves your body and soothes your mind. This is a great way to deal with chronic pain without letting it get the best of you.

Head injuries can be scary and residual effects even more so; the more educated you are about your injury, the more involved in your care plan and the more willing you are to fight to overcome it, the better your chances of a full recovery. Chronic pain can be a lasting effect of your injury and it can be life-changing, but that doesn’t have to be for the negative. Dealing with chronic pain can leave you a stronger individual than you were before your injury, taking on challenges and completing them with strength you never knew you had.

Suicide and Pain: Research Explores Links to Suffering, Acceptance, Burden

Posted on 05.6.15 |

Full Article: http://www.painmedicinenews.com

NATIONAL HARBOR, MD—Walking among his three clinical research posters at the recent annual meeting of the American Academy of Pain Medicine, pain expert David Fishbain, MD, stopped in his tracks and stated the obvious.

“As you can probably tell,” the Pain Medicine News editorial advisory board member said while waving at the three pieces of research he was involved in, “we are pretty interested in suicidality.”

That interest has spawned a series of studies on various psychological aspects of suicidality in pain patients from Dr. Fishbain and his colleagues from Florida’s University of Miami School of Medicine. The three works explore questions surrounding the effects of burden, acceptance and suffering on both pain and suicidality. The studies, presented in poster form at the AAPM meeting, also touch on specific predictors and screening strategies to assess for suicidality in a pain population.

The Burden of Burden

Dr. Fishbain and his colleagues explored the role that feeling like a burden plays in both acute pain patients (APP) and chronic pain patients (CPP) with regard to suicidality (poster 153). Self-perceived burden (SPB) has been linked to depression and suicidality (Pain 2012;153[8]:1735-1741).

The current study looked specifically at pain patients and theorized that SPB rates would be higher among CPPs than the other two groups. It also examined whether those who perceived themselves as a burden would be more likely to be suicidal, positing again that suicidal affirmation would be higher among CPPs.

“The theory behind the study’s burden item was that it should present at greater rates in CPP than the other groups,” said Dr. Fishbain. This proved true, as SPB was found in 102 CPPs (30%), but was also seen in 54 APPs (17%; P=0.00). In both CPP and APP groups, the link to SPB was statistically significant.

The researchers also found SPB occurring at a greater frequency in CPPs who had affirmed suicidality compared with APPs and non-patients who affirmed suicidality. They found that SPB was a significant predictor of all five types of suicidality studied (passive, active, “I’d rather be dead,” suicide plan and suicide attempt).

“The affirmation of burden is a strong predictor of suicidality,” concluded Dr. Fishbain. “You could theoretically ask if they feel like a burden, and that question alone could predict risk for suicidality.”

Dr. Fishbain and the investigators concluded that all CPPs and APPs should be evaluated for suicidality.

Acceptance Theory

Another study focused on the role that acceptance of pain plays in both APPs and CPPs (poster 154).

“Pain acceptance is a big thing in treatment now,” said Dr. Fishbain, MD, Department of Psychiatry, Miami VA Medical Center, and Departments of Psychiatry, Neurologic Surgery and Anesthesiology, University of Miami School of Medicine, defining it as a “behavior pattern with awareness of pain but not directed at changing pain.”

Evidence demonstrates, he said, that patients who accept their pain and do not seek much or any care do better. For example, he said, “they quit going to the doctor a lot, and are more rehabilitation-oriented” (Curr Pain Headache Rep 2006;10:90-94).

Generally speaking, the longer a patient is in pain, the more they come to accept their situation, which to Dr. Fishbain may be key.

“Acceptance could be a function of time,” said Dr. Fishbain. “You can almost boil it down to one item: ‘Do you accept that there is no cure to your pain?’ in terms of whether or not there is suicidality. The longer you’ve accepted that there is no cure, the better you feel.”

APPs and CPPs were compared in terms of how many times they endorsed two items: “little hope of getting better” and “physical problems [pain] can’t be cured.” Patients with chronic pain were statistically significantly more likely than those with acute pain to affirm these two items.

The investigators then theorized that, given its nature, chronic pain would distinguish itself from acute pain (Table). “This was indeed the case,” said Dr. Fishbain. “Chronic pain patients are more likely to accept their pain, acceptance again probably being a function of time. They come to terms with knowing that a cure is unlikely and that there is little hope of getting better; these are all aspects of acceptance.”

When The Prescription Becomes The Problem

Posted on 05.6.15 |

Join the campaign! Visit: http://www.cdc.gov/drugoverdose/media/index.html for more info

Starting April 6^th, help us tell the stories of the many people whose lives have been affected by prescription painkiller addiction or the death of a loved one. Encourage those in need to seek treatment for addiction. Celebrate others who are already working to change lives, and inspire our communities to improve patient safety and the way we treat pain.

Write your six-word story or message
Create an original picture or a video tagged #RxProblem
Post on Facebook, Instagram and Twitter by May 15
Ask your friends and followers to help raise awareness with you by sharing their six-word story and picture/video

Top Causes of Chronic Pain

Posted on 05.4.15 |

People with persistent pain often think of themselves as suffering from a specific ailment, whether it’s arthritis, back pain, migraines, or something else. But anyone who has experienced pain for several months or longer also happens to be among the millions of Americans with a condition known as chronic pain.

Chronic pain is a complex condition that affects 42 million-50 million Americans, according to the American Pain Foundation. Despite decades of research, chronic pain remains poorly understood and notoriously hard to control. A survey by the American Academy of Pain Medicine found that even comprehensive treatment with painkilling prescription drugs helps, on average, only about 58% of people with chronic pain.

What causes chronic pain, and what can you do about it?

Some causes of chronic pain can be traced to a specific injury that has long since healed — for example, an injury, a serious infection, or even a surgical incision. Other cases have no apparent cause — no prior injury and an absence of underlying tissue damage. However, many cases of chronic pain are related to these conditions:

Treating your underlying condition is, of course, vitally important. But often that does not resolve chronic pain. Increasingly, doctors consider chronic pain a condition of its own, requiring pain treatment that addresses the patient’s physical and psychological health.

Understanding the Psychological Impact of Chronic Pain

At a fundamental level, chronic pain is a matter of biology: Errant nerve impulses keep alerting the brain about tissue damage that no longer exists, if it ever did. But complex social and psychological factors are also at play, and they seem to help determine who fares well despite even severe chronic pain — and whose lives quickly unravel.

Negative emotions, including sadness and anxiety, seem to aggravate chronic pain. For example, people who dwell on their discomfort tend to be more disabled by chronic pain than people who try to take their pain in stride. And among people with chronic pain stemming from a work-related injury, those who report poor job satisfaction fare worse than those who say they like their jobs. (read full article on WebMD)

Pharmacist Survey Raises Concerns for Patient Access to Generic Pain Drugs

Posted on 04.20.15 |

Patient access to generic pain and other prescription drugs and community pharmacies are both increasingly at risk due to inadequate reimbursement rates that fail to cover the cost of filling prescriptions, according to a recent National Community Pharmacists Association (NCPA) survey.

Morphine was among the medications that did not have adequate reimbursement, the survey said.

“For decades, community pharmacists have promoted the appropriate use of generic drugs to lower costs. However, more recently the price for some of these medications has skyrocketed 1,000% or more virtually overnight while reimbursement rates paid to community pharmacists have inexcusably lagged behind for weeks or months,” said NCPA CEO B. Douglas Hoey, RPh, MBA.

The new survey asked 700 pharmacists to describe their experiences in this area since an earlier 2014 survey first documented the problem. Virtually every pharmacist experienced a “large upswing” in the acquisition cost of a generic drug over the past six months, with approximately 80% stating that this occurred in at least 26 instances during this period, and 93% said the problem has grown worse since an NCPA survey done in 2013. (read full article)

SCS vs CMM-A Controlled Trial

Posted on 04.15.15 |

Spinal cord stimulation versus conventional medical management for neuropathic pain: A multicentre randomised controlled trial in patients with failed back surgery syndrome

Abstract

Patients with neuropathic pain secondary to failed back surgery syndrome (FBSS) typically experience persistent pain, disability, and reduced quality of life. We hypothesised that spinal cord stimulation (SCS) is an effective therapy in addition to conventional medical management (CMM) in this patient population. We randomised 100 FBSS patients with predominant leg pain of neuropathic radicular origin to receive spinal cord stimulation plus conventional medical management (SCS group) or conventional medical management alone (CMM group) for at least 6 months. The primary outcome was the proportion of patients achieving 50% or more pain relief in the legs. Secondary outcomes were improvement in back and leg pain, health-related quality of life, functional capacity, use of pain medication and non-drug pain treatment, level of patient satisfaction, and incidence of complications and adverse effects. Crossover after the 6-months visit was permitted, and all patients were followed up to 1 year. In the intention-to-treat analysis at 6 months, 24 SCS patients (48%) and 4 CMM patients (9%) (p < 0.001) achieved the primary outcome. Compared with the CMM group, the SCS group experienced improved leg and back pain relief, quality of life, and functional capacity, as well as greater treatment satisfaction (p ⩽ 0.05 for all comparisons). Between 6 and 12 months, 5 SCS patients crossed to CMM, and 32 CMM patients crossed to SCS. At 12 months, 27 SCS patients (32%) had experienced device-related complications. In selected patients with FBSS, SCS provides better pain relief and improves health-related quality of life and functional capacity compared with CMM alone.

>> Full Article on Science Direct click here

Complex Regional Pain Syndrome-Distract Yourself

Posted on 04.8.15 |

Do you ever notice that when your distracted from pain you tend to feel a bit less? Maybe you went on vacation and felt a little less pain than before. Florida pain management physician, Dr. Pyles, suggests some fun to take you mind off of the stress that chronic pain can bring. It’s quite remarkable how our brain processes pain, and how effective distraction can be.

Austrailian hospitals are using a remarkable new treatment that effectively tricks the brain of an injured patient into thinking their problem has deteriorated or gone away.

Austin Health physiotherapist Anne Daly said the technique, which involves the use of mirrors, was helping patients recover from Complex Regional Pain Syndrome, a grueling condition that causes unrelenting pain in a person’s limb, usually after they have suffered an injury.

She said research showed that getting patients with the syndrome to practice exercises with both their non-affected and affected limbs while looking in a mirror had helped to reprogram the cause of their syndrome deep within their brains. – BrisbaneTimes.com

This new mirror technique of pain management has been shown to significantly reduce pain in “around a third of the patients” that uses this as a form of chronic pain treatment. The therapy is also used for patients who have lost limbs and suffer from “phantom limb pain” where the brain sends faulty signals to a limb that is no longer there.

Back Packs and Back Pain

Posted on 04.6.15 |

Back Packs and Back Pain

I’m sure I’ve mentioned this a few hundred times before, but back pain affects over 35 million Americans, including many Florida residents. It is one of the most prevalent chronic pain conditions that U.S. adults face every single day. Whether it’s because you sit at a computer all day, your are in construction or you serve at a restaurant all day, back pain affects us all.

Statistics show that this form of pain is the single most common reason for missed work, and the second most common reason for visiting the doctor. So, as the kids head back to school, let’s take some time to investigate and provide solutions to backpacks and back pain and getting off on the right foot.

Back To School

These days many Florida schools do not have one set of books for home and a separate set of books for school, it’s just one set of books that kids have to lug from one place to another in their backpacks. Those backpacks get heavy, uneven, and tattered quite easily, and with no lockers to use either it’s up to the strength of backs to carry the weight.

According to the American Physical Therapy Association, the weight of your child’s backpack should not exceed 15% of total body weight. If your child is carrying a heavy load, perhaps too many books or school supplies, it can place a great deal of strain on the muscles that support the back, thus leading to back and even shoulder pain. If the weight is too heavy, the backpack can actually pull the child backwards, in which the child will compensate by leaning forward at the hips or arching the back. This can cause the back to compress unnaturally, leading to increased pain. As with adults, many kids will not share this pain with their parents, and will just “tough it out,” assuming it’s just a part of being a student.

Do what you can to educate your child on the risks of wearing their backpack over just one shoulder. Sure, it has always been the ‘cool’ way to wear a backpack, but it is also the most detrimental in terms of throwing out vertebra in the back and placing unnecessary weight on back muscles. Because the backpack weight is unstable and unbalanced, one side of the body, one side of the back muscles, and one shoulder will take all of the strain.

Wearing the backpack too low on the back can put increased pressure on the shoulders and neck muscles, thus affecting the spine and back by increasing an imbalance in the spine.

Finally, if the child has a backpack with tight, narrow straps, those straps can interfere with circulation and nerves within the shoulder. This can cause pain, tingling, even numbness.

The Perfect Backpack

Having the right backpack, the right length straps and the right amount of weight within the backpack can save your child a lot of strain and irritability. In order to avoid back pain, the child must wear the backpack on both shoulders, keep the weight light, and maintain balance at all times.

A canvas backpack is always better than leather or plastic, as it will conform to the back and maintain balance better. The backpack straps must be adjustable, and at least two inches wide to evenly distribute the weight. The backpack should have individualized compartments in various locations to help evenly distribute the weight as well. If your child is required to carry books from class to class, as many are these days, you’ll need a backpack with a hip strap or waist belt to redistribute the weight from the shoulders and back to the pelvis. Finally, if possible, use a backpack with wheels so that you can avoid wearing one altogether.

With the kids back to school, they might be too excited, or nervous, to mention how heavy their backpacks are getting. They might try to tough out the pain or the struggling. But if you notice any increased irritability or tenderness in the back, start looking to your physician for back pain suggestions.