Decoy Molecule Could Stymie Chronic Pain

rnaResearchers at the University of Texas at Dallas believe they have created a new weapon in the war against chronic pain. According to researchers, they say they’ve created an RNA-mimicking molecule that can block a series of pain sensations that normally occur after an injury. By studying how this molecule interacts with pain sensations, researchers believe they may be able to develop a new class of drugs that can prevent pain at the outset without increasing a person’s risk of addiction.

“Our results indicate that local treatment with the decoy can prevent pain and inflammation brought about by a tissue injury,” said study lead author Dr. Zachary Campbell.

He believes the findings are very important because chronic pain-related conditions are “the primary reason Americans are on disability.”

“Poorly treated pain causes enormous human suffering,” said Dr. Campbell, “as well as a tremendous burden on medical care systems and our society.”

Cutting In To Opioid Abuse

Opioid addiction and overdoses have increased in recent years as more people turn to pills to help manage their pain. In the right hands with the right dosage, opioids can play an integral role in a pain management plan. However, opioids can be a slippery slope to addiction if they are abused, which is why researchers are looking to develop new medications that are abuse deterrent.

Our current opioids have a major disadvantage in that they interact with areas of our brain that deal with reward and emotion. This can lead to a craving or addiction to the reward stimulus that the drugs provide, but by studying the artificial RNA-molecule, we may be able to develop drugs that stop pain in other areas of the body without crossing the brain-blood barrier.

This artificial molecule works in nociceptors, which are special cells at the injury site that help send pain signals to the brain. After the injury, RNA molecules begin the process of facilitating proteins that signal pain. By mimicking RNA, the decoy molecule can interrupt this process that makes these proteins, and reduce our body’s behavioral response to pain.

“When you have an injury, certain molecules are made rapidly. With this Achilles’ heel in mind, we set out to sabotage the normal series of events that produce pain at the site of an injury,” said. Dr. Campbell. “In essence, we eliminate the potential for a pathological pain state to emerge.”

This is certainly an interesting development, and I hope it opens up new ways to combat chronic pain. We’ll keep an eye out for more information about this protein in the coming years, as it may have big implications for how pain is managed.

Chronic Pain and Your Credit Score – An Interesting Link

chronic pain creditChronic pain has many obvious drawbacks, but it also has many hidden consequences. We know that chronic pain can be costly to treat, but new research suggests that it can have a severe impact on your buying power or your ability to secure credit.

According to a new study published in the National Pain Report, a survey of 840 chronic pain sufferers found that a whopping 63 percent were unable to secure credit. As you might have guessed, this has far-reaching consequences for pain sufferers.

Chronic Pain and Your Credit

Researchers said that there were a number of different reasons why chronic pain sufferers had difficulty securing credit. Some of the most common challenges individuals with chronic pain run into credit-wise include:

  • Difficulty obtaining credit because chronic pain makes it hard or impossible for them to maintain employment.
  • High interest on credit cards or loans that they are able to secure.
  • Difficulty getting a cell phone contract.
  • Inability to get approved for a home loan or apartment rental.
  • Inability to secure utilities, like electricity, propane or gas.
  • Difficulty getting automobile or life insurance, and when they do, rates are often very high.

“The inability to secure credit brings a long list of challenges, particularly for those who also suffer with medical conditions, like pain,” said Jim Shanahan, President and CEO of Prepaidian, Inc, a company who specializes in Prepaid debit cards that are intended to provide buying power for people who are unable to secure credit. “You may be unable to get a checking account, or pay exorbitant fees on those accounts, in addition to trying to manage medical bills.”

How To Improve Your Credit While Dealing With Chronic Pain

Improving your credit score while you deal with chronic pain isn’t always easy, but there are things you can do to improve it bit by bit. For example, always try to make your payments on time, even if it’s just the minimum amount. Paying on time helps to improve your credit score. Secondly, don’t be in a rush to close your accounts. Closing accounts, even ones you don’t use, negatively impacts your credit score because it limits your buying power. If you absolutely have to close out an account, see if you can increase your line of credit on a different account. Even if you don’t plan to spend that much, your credit score improves when you have more potential buying power at your disposal.

Secondly, try to settle up past due accounts. Odds are if you’re willing to pay at least a portion of the bill, the credit card company will be willing to erase the debt, because getting some money is better than getting nothing. You can call in and see if they’ll waive late fees or some interest charges, because it never hurts to ask, and if waiving a fee gets the credit card company their money, oftentimes they’ll be willing to compromise. It never hurts to ask.

Lastly, if medical bills from chronic pain are stacking up, try to get on a payment plan with your health center or insurance company. Making regular payments and working towards a zero balance will do wonders for your credit score. Explain your situation, and people may be more willing to help.

Thoughts On Attending The Latest Pain Conference

conference meetingEvery physician is required to obtain continuing education credits. Depending on a when one was board certified, the types of boards one has, and what state you live in, the number of credits needed each year varies.

At least once a year, I try to attend some sort of conference in order to to add to my knowledge about how to treat pain. This year I have ventured into the new realm of the American Society of Regional Anesthesia (ASRA). Since pain care crosses the line into a number of different disciplines, one of the best ways to improve is to pick up knowledge outside your normal specialty.

Thoughts From The ASRA Meeting

For the last several days I have been at the annual pain meeting of the ASRA. It is a group of about 5,000 practitioners, which is actually one of the smaller major groups involved in pain management. Each group has a different focus, and finding a good balance is hard. So far I have enjoyed the meetings; it’s like being back in an intense school all day long. Best yet, most of the information has been very relevant to my regular practice. It also has included a lot of practical knowledge, and there hasn’t been too much esoteric academic information or stuff aimed at an someone just beginning to practice pain medicine. Many of the pain conferences are aimed at physicians who do not do any advanced procedures or only at physicians doing injections, and both extremes can be lacking balance for patient treatment.

One of the most important things a conference does is challenge your thinking. Hopefully questions are entering your mind about what can you improve upon and how to do better patient care. A conference like this is great. It is not focused on a single topic and there are many areas of my practice it could impact. General topics have ranged from very specific aspects of implantable pain technologies to the best ways to evaluate and treat very specific medical problems. One odd topic that has caught my interest is how to deal with changing government regulations to prevent burnout of physicians.

The hot topic at any of these conferences is now opioid use and abuse. However, at a pain conference it is not about a crisis of addiction, but a crisis of lack of treatments available to treat complex pain. The money is being spent on addiction management and not finding treatments that would manage the root cause of pain, and thus markedly reduce addiction.

The hardest thing at a conference (besides sometimes staying awake) is trying to sift through what is truly good information. After going to enough of these conferences, one begins to recognize those who are in it for self promotion. Every conference seems to have several people who promote the latest fad. If there is no money to be made with regards to a topic, the information is probably more science and less sales.

Learning new information is good. Missing seeing patients is tough, but the time gone is for the good of all patients in order to provide the best care. Benefits will be made on everything from what to do for patients to learning new things that may help tough patients. New treatments now will be tried for everything from CRPS to knee or elbow problems. The only sad part of going to these conferences is that often I see no other pain physicians from my location, but I’m certainly glad I went to this conference.

Minnesota Getting $16.6 Million To Fight Opioid Epidemic

opioids chronic pain minnesotaMinnesota is set to receive $16.6 million in federal grants that will be given to foundations and organizations committed to fighting the opioid epidemic.

More than 30 different agencies will receive grants from the federal fund, and the goal is to reach and help more than 110,000 Minnesotans who are seeking treatment for opioid dependency. Most of the money will go to existing programs to launch new efforts or expand current efforts in combating the opioid crisis.

“These grants are designed to build on what we are doing,” said Minnesota Human Services Commissioner Emily Piper.

The Opioid Problem In Minnesota

According to health data, there were nearly 2,500 opioid-related overdoses last year, and 376 of those overdoses were fatal. There were more than 3.5 million prescriptions written for opioid painkillers in Minnesota in 2016.

The federal grant will go to a number of specific places and programs, including:

  • More widespread availability of naloxone, a key substance in helping save people who have overdosed on painkillers.
  • Expanding medication-assisted treatment.
  • Increasing aid and resources on American Indian reservations.
  • Adding opioid-specific care providers throughout the state.
  • Establishing a program to help unborn and newborn babies of mothers with opioid dependencies.

There has also been a push for more regulation at the national level from Minnesota lawmakers. A presidential opioid crisis commission recommended that President Trump support two bills proposal by Minnesota Senator Amy Klobuchar. The first would require more monitoring of drug prescriptions and the second would attempt to reduce the number of opioids that are being illegally distributed through the US mail system.

Electricity’s Role In Chronic Pain Management

electrical neurostimulationElectricity and its role in treating chronic pain oftentimes gets a bad rap because some people automatically associate neurostimulation with shock therapy. Yes, electrical current is used in order to help quell your pain, but we’re not sending painful volts into your body like you sometimes see in Hollywood films. With opioids becoming a growing concern in many circles, more professionals and medical researchers are looking to see if electricity could be the next big thing in chronic pain management.

Nueromodulators and Chronic Pain

Neuromodulation or neurostimulation is not exactly a new approach to chronic pain management, as versions of these devices have been around for decades. Like any medical device, the first prototypes are a step in the right direction, but it takes a while for researchers to work out the kinks and really perfect the technology. Dr. Mark Malone, founder of Advanced Pain Care in Texas, believes we’re getting much closer to perfecting these neuromodulators.

“In the last 18 months or so, a new generation has come out including (Abbott’s) Burst and Dorsal Root Ganglion,” said Malone. “These two techniques are far more effective and it’s really an amazing revolution. For the first time ever, we’ve been able to say things like ‘cure chronic pain.'”

So how exactly does neuromodulation work? Essentially, it uses electrical impulses to trick the brain into believing the area is no longer sending pain signals.

“This is the application of electrical energy in the nervous system to quiet down pain impulses,” said Malone. “It’s more of a language. You’re speaking to the nervous system in the language of the nervous system and telling the brain the pain is no longer important.”

Neuromodulation is similar to the process that happens if you were to accidentally hit your thumb with a hammer. When you do this, you probably grab your thumb and rub it to help dull the pain. By rubbing your thumb, you’re providing the area with a new sensory signal and helping to block the pain signal. This process is known as tonic stimulation, and it’s an underlying principal of the electrical stimulation process. The small implantable device can drown out pain signals by stimulating other areas.

No Addictive Side Effects

Dr. Malone has been using a neuromodulator of his own for a little over six months. He had been on disability for more than a year and only working at his clinic on a part-time basis, but after seeing how successful it was for his patients, he decided to give it a shot for his pain. He’s been thrilled by the results, and electrical stimulation does not have the same potential drawbacks as opioids.

“It’s really an amazing gift that we suddenly have this treatment that’s so effective for even the worst pain patients and it’s completely drug free,” said Malone, noting that electricity isn’t addictive and that it produces no euphoric side effects.

The neuromodulator isn’t a perfect device, but it’s a big step in the right direction. It can’t stop certain types of pain, like widespread fibromyalgia, but it has been successful in patients with certain types of complex regional pain syndrome and failed back surgery syndrome. So if you’re still looking for answers to your chronic pain problem, ask a pain management specialist about your options with neuromodulators and electrical stimulation.