Articles related to Pain Medicine

The literature on chronic pain and stigma was reviewed by a group of academics from Sapienza University of Rome, Italy, who published their findings in the journal Pain and Therapy. Perhaps most unexpectedly, they discovered that stigma surrounding pain persists even in clinical settings, resulting in clinicians’ inadequate evaluations of patients’ pain, doubt about the reality of their suffering, and lower pain ratings. These factors frequently result in inadequate treatment of pain and a propensity to believe that it is solely a psychological disorder.

This 70-study meta analysis concludes that the evidence is moderate to high that bisphosphonates and denosumab reduce the risk for hip, vertebral, and other fractures. The evidence is moderate to high that abaloparatide and teriparatide reduce clinical fractures and radiographic vertebral fractures, and low to moderate that SERMs reduce radiographic vertebral fractures, but not clinical fractures.

Beyond the strong recommendation for bisphosponates as initial medical therapy in postmenopausal women with osteoporosis, the updated guidelines also suggest (not recommend) denosumab as second line therapy in women, bisphosphonates for osteoporosis in men, and romosozumab in women with very high risk of fractures. For the complete updated guideline, see Pharmacologic Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults: A Living Clinical Guideline From the American College of Physicians.

In a study of more than 800 rural-living men and women with knee osteoarthritis, an 18-month program of diet and exercise versus attention control yielded an average 14-pound greater weight loss in the test group – but not much difference in pain magnitude.

Chronic pain affects more than 20% of the US population. More than a dozen new medical therapies are being developed to improve quality of life and reduce the risk of addition. This report summarizes the status of 17 new pain management medications in the pipeline: 16 in phase 3 trials and one newly approved.

By 2018, gabapentin and opioids were prescribed in an overlapping manner in 7.6% of prescriptions. Prescribers are likely responding to restrictions on opioid prescribing put in place during the opioid epidemic. Increased co-prescribing was most frequently done under the direction of a pain specialist. Still, the effectiveness of the concurrent prescribing of opioids and gabapentin is uncertain and potentially dangerous because of an association with all-cause and drug-related hospitalizations.