Every year, we chronicle the latest in pain research on our blog. You can find all of those reports here. This year’s pain research promises even more exciting developments. From safer opioid options to virtual reality, here are 25 of the top stories from 2017 pain research!
Complementary approaches to pain management
2017 pain research focused heavily on complementary therapies that could manage pain symptoms, without patients relying on opioids. From exercise to radiofrequency ablation for back and knee pain, here’s what researchers discovered.
1. A single hour of exercise a week can prevent depression
Depression is one of the leading comorbid symptoms with chronic pain. New research shows that even as little as one hour a week could reduce your chances of this. This large-scale study of over 33,000 Norwegian adults found that:
“[P]eople who reported doing no exercise at all at baseline had a 44% increased chance of developing depression compared to those who were exercising one to two hours a week.”
Study author, Professor Samuel Harvey, lead of the international research team, noted that:
“We’ve known for some time that exercise has a role to play in treating symptoms of depression, but this is the first time we have been able to quantify the preventative potential of physical activity in terms of reducing future levels of depression. These findings are exciting because they show that even relatively small amounts of exercise — from one hour per week — can deliver significant protection against depression.”
2. Acceptance and commitment therapy (ACT) could significantly help with pain
Cognitive behavioral therapy, or CBT, has long been used to help resolve some of the accompanying symptoms of chronic pain. However, a team from King’s College London recently set out to examine benefits of acceptance and commitment therapy for pain, a more specialized form of therapy. Their findings, published in the Journal of Pain, found that:
“Overall, the results showed significant improvements after treatment. Participants had considerably improved outcomes, and these improvements were confirmed after 9 months. Specifically, up to 67.5 percent of the participants showed “meaningful improvements” both after the treatment and at the 9-month follow-up. Furthermore, changes in SAC (self-as-context, an aspect of ACT) were found to correlate with changes in each of the treatment outcomes: pain-related interference, work and social adjustment, as well as depression. In other words, increases in SAC seemed to improve functioning in people with chronic pain.”
3. New evidence for pulsed radiofrequency for low back pain
A study presented at the Radiological Society of North America (RSNA) reported that pulsed radiofrequency helped resolve back pain for a majority of patients, in an admittedly small trial. With the help of CT imaging, doctors delivered pulsed radiofrequency energy to patients with herniated discs for a 10-minute period. They saw these results:
“The results have been extraordinary. Patients have been relieved of pain and resumed their normal activities within a day. Of the 80 patients treated, 81 percent were pain free one year after a single 10-minute treatment session. Six patients required a second pulsed radiofrequency session. Ninety percent of the patients were able to avoid surgical treatment.”
4. Radiofrequency ablation for knee osteoarthritis?
Just as radiofrequency ablation showed promise for back pain, a study printed from Regional Anesthesia & Pain Medicine found that cooled radiofrequency ablation could help reduce knee pain and improve function. This approach was tested against more commonly-prescribed knee steroid injections.
Researchers found that:
“Patients undergoing CRFA had significant and lasting reduction in pain scores. From an initial pain score of about 7 on a 10-point scale, pain ratings at one month were about 3 in the CRFA group versus 4 in the steroid group. With further follow-up, pain scores remained lower in the CRFA group while increasing toward the pre-treatment level in the steroid group. At six months, 74 percent of patients assigned to CRFA had at least a one-half reduction in pain scores, compared to 16 percent of those undergoing steroid injection. Forty percent of patients in the CRFA group rated their knee function “satisfactory” at six months’ follow-up, compared to just three percent of the steroid group. Ninety-one percent of the CRFA group felt their overall health had improved, compared to 24 percent in the steroid group.”
Reducing opioid use
While opioids provide patients with relief after they’ve exhausted every other option, these medications can be particularly harmful if used incorrectly. Further, they don’t treat the underlying condition leading to pain. 2017 pain research looked at multiple ways to reduce dependence and safer options that contained the same pain-relieving benefits.
5. Holistic therapies could reduce opioid dependence
An article from the health news branch of NPR reported recently on a Mayo pain rehabilitation center that focuses on one thing: reducing opioid use through complementary practices. They do this with approaches like physical therapy and cognitive behavioral therapy, tackling pain on an emotional, psychological, and social level.
“By the time patients enroll, many have tried just about everything to get their chronic pain under control. Half are taking opioids. But in this 40-year-old program, they can’t stay on them. Participants must agree to taper off pain medications during their time at Mayo. Still, more than 80 percent of the patients who enroll remain through the entire program, says Wesley Gilliam, the center’s clinical director. And many previous opioid users who finish the treatment report six months later that they have been able to stay off those drugs. Just as important, he adds, they have learned strategies to deal with their pain.”
6. Team-based approach could decrease opioid use 40%
A 2017 pain research study into opioids and effective approaches to minimizing their use found one technique that truly worked: a team-based, primary care model. They found that those patients who used this approach reduced their reliance on opioids by 40%. The study, published in JAMA Internal Medicine, noted:
“The TOPCARE (Transforming Opioid Prescribing in Primary Care) model brings a nurse care manager into the equation to discuss treatment plans with patients suffering from chronic pain, and to ensure monitoring occurs; provides online resources to assist prescribers, and coordinates an individualized educational session for primary care providers conducted by an expert in opioid prescribing.”
7. What about safer opioids?
While it’s always important to use complementary measures to reduce opioid use, what if you redesigned the medication itself? 2017 pain research published in the journal Cell looked at how to do that. Specifically, they tried to design opioids that didn’t lead to the respiratory issues that cause opiate overdose. They designed:
“[N]ew compounds could indeed enter the brain — and all of the compounds were as potent, if not more so, than morphine. The compounds that were less able to promote barrestin2 associations in cells were also less likely to induce respiratory suppression in mice.”
The tech world meets chronic pain management
Finally, the tech world is beginning to investigate new ways to manage pain symptoms. From VR to at-home treatments, here’s what they found.
8. Beyond opioids, to treat a previously-unknown pain pathway
Researchers at the University of Texas at Austin may have developed a new synthetic compound, UKH-114, that acts on a previously-unknown pain pathway. The benefits? It works at a lower dose, with longer duration of action.
The article notes that researchers:
“[T]ested UKH-1114 on mice with nerve damage and found that it alleviated pain as well as gabapentin did, but at a much lower dose (one-sixth as much) and was effective much longer (lasting for a couple of days, compared with 4 to 6 hours). This research is the first to demonstrate that the sigma 2 receptor may be a target for treating neuropathic pain.”
9. Could you reduce pain… with virtual reality?
Earlier this year we reported on the benefits of VR for pain treatment. A newer article from Singularity Hub goes into more detail of how this technology could be used to treat consistent, chronic types of pain. The article notes that:
“AppliedVR is now turning their attention to chronic pain by developing VR-based methods borrowed from other types of cognitive behavioral therapies and mindfulness-based techniques. One of the exercises uses a sensor to monitor the patient’s breathing to ensure they maintain a slow and steady pace. As their breathing matches the ideal state, the patient will see an intricate puzzle-like structure forming inside their headset as a type of visual reward to reinforce progress. Sackman says this kind of sensor-based biofeedback will help patients learn to control their breathing and increase relaxation to cope with pain.”
10. New start-up raises $8 million to tackle chronic pain with tech
One company thinks that tech is the way to stop chronic pain. They think they can stop it before it progresses into something more severe that requires surgery. An article in Business Insider notes that:
“The startups’ cofounders, Daniel Perez and Gabriel Mecklenberg, argue that chronic pain can be treated effectively with ‘continuous, high-touch care.’ It’s onerous to keep going back to your doctor, though, so you end up coping with the pain, then taking a more expensive option which doesn’t always work, like surgery or opiates. Hinge Health wants to intervene before it gets to surgery or strong painkillers. The company supplies pain sufferers with health kits, which includes two bands with motion sensors, and a tablet with Hinge Health’s software. People can get the kits through their employers, if they’re signed up, or their own health plan. The kit takes patients through a 12-week digital programme which educates them about their condition, guides them through exercises, and teaches them to break bad habits. Hinge Health claims people who go through its programme see at least a 50% reduction in pain.”
15 more 2017 pain research findings
These are just the beginning of the pain studies that came out in 2017. Find our 2017 pain research coverage from the beginning of the year here. That post covers 15 findings from June and earlier that answer questions like:
- Could your relationship with your spouse affect your pain?
- Can staying active prevent chronic pain in older adults?
- Could less opioids actually lead to less pain?
Want to ask specific questions about this 2017 pain research, and how it could affect you? Find a doctor in your area who specializes in chronic pain by clicking the button below.