Roger B. FiLLiNGiM PhD
Colleen M. FiTZGERALD MD, MS
Michael R. CLARK MD, MPH, MBA
A prominent psychiatrist and pain educator discusses the challenge of managing patients with chronic pain who also suffer with borderline personality disorder and depression, including the special difficulties associated with demanding, noncompliant, and high-utilizer patients. Dr. Clark is Vice Chair of Clinical Affairs, Johns Hopkins University School of Medicine, the Director of the Adolf Meyer […]
John J. BURKE
- Seeks Increased Funding, Improved Treatment Access, Better Clinician Education for Pain
In a feature article appearing in the December issue of The Journal of Pain, the American Pain Society presents its Pain Research Agenda for the 21st Century, which it describes as identifying promising but underfunded approaches to develop new treatments and to help make currently used pain medications safer and more effective. Co-author, former APS President, and longtime PAINWeek faculty member Roger Fillingim, PhD, stated “Our work in developing the pain research agenda showed that even the most optimistic estimates indicate that pain research is woefully underfunded relative to its prevalence, disease burden and economic toll.” The APS describes the Pain Research Agenda as a goal-oriented approach emphasizing important outcomes that must be achieved to meaningfully advance pain treatment. It notes that pain research expenditures at the National Institutes for Health (NIH) account for just 1 percent of the NIH research budget or $4 per affected individual, compared to cancer and HIV for which $431 and $2,562, respectively, are spent per affected person. Read a news story about the recommendations here. The journal abstract, with additional link to the full article, may be accessed here.
- New Engineered Peptide Also Improves Metabolic Control
An article published last month in the journal Molecular Medicine details findings from a study reporting clinically significant pain reduction in patients with type 2 diabetes following administration of the peptide ARA 290. Investigators also observed improvements in metabolic control in patients who received the agent. The exploratory study was conducted by Araim Pharmaceuticals, a biotech company developing novel treatments for chronic diseases. ARA 290 is a peptide engineered to activate the innate repair receptor, a receptor discovered by Araim scientists, which is only expressed following tissue damage or stress. Neuropathic pain is a common condition among patients with diabetes. When ARA 290 is administered, the repair receptor is activated and subsequently turns off inflammation and turns on the body's natural repair system. The short half-life of ARA 290, coupled with the restricted expression of the innate repair receptor, functions as a dual safety system to avoid potential side effects. Read more about the study findings here. The text of the published article (marked as an uncorrected proof) may be read here.
- Study Suggests Importance of Integrated Treatment of Insomnia and Back Pain
A new study conducted by the University of Haifa concludes that insomnia is a marker for increased risk of back pain—the risk factor increasing by 150%! Among women, the correlation between insomnia and back pain was even higher. Insomnia is known to increase sensitivity to pain and those suffering from it are liable to experience spontaneous pain more often and with more intensity compared to others. However this study is the first to show a direct connection between insomnia and back pain. The robustness of the study findings are supported by the size of the subject population (over 2,000), its heterogeneity, the fact that those with health problems were weeded out and not included in the final results, and the lengthy period over which the study was conducted. Researchers speculate that the link between the 2 conditions stems from a yet-to-be-identified third biological factor, one possible candidate being stress level. Read a news story about the study here.
- American Migraine Foundation Offers Guidance on Food Triggers
Guidance on identifying and avoiding food and drink that can trigger migraine is now available on the American Migraine Foundation (AMF) website. The Chair of AMF, and past PAINWeek faculty member, David W. Dodick, MD, FRCP (C), FACP, notes that the holidays are a time when people are prone to overindulgence in food and beverage choices that can prompt migraine attacks. Specific advice on reducing migraine risk while enjoying holiday celebrations include: identification of potential dietary triggers by keeping a migraine “diary”; maintaining a regular meal schedule without skipping; and moderation in alcoholic, caffeinated, and carbonated beverage consumption. Dr. Dodick observed that not everyone with migraine has food triggers, but for those with these triggers, avoiding them can often mean fewer migraine attacks. An article with links to further information on migraine food triggers may be read here.
Department of Public Health and Community Medicine
Tufts Medical Center