The drugmaker Purdue Pharma launched OxyContin two decades ago with a bold marketing claim: One dose relieves pain for 12 hours, more than twice as long as generic medications. OxyContin’s stunning success masked a fundamental problem: The drug wears off hours early in many people, a Los Angeles Times investigation found. OxyContin is a chemical cousin of heroin, and when it doesn’t last, patients can experience excruciating symptoms of withdrawal, including an intense craving for the drug. The problem offers new insight into why so many people have become addicted to OxyContin, one of the most abused pharmaceuticals in U.S. history.
"If she had been alone, with no one to agitate for her care, there’s no telling how long she might have waited." Nationwide, men wait an average of 49 minutes before receiving an analgesic for acute abdominal pain. Women wait an average of 65 minutes for the same thing.
Health-conscious people are haunted by the idea that they “should” correct their posture, and many fight a chronic, uncertain and tedious battle against crookedness. But is it necessary? After working as a massage therapist for many years, I became confident that poor posture is a “real” thing. I think it is sometimes a factor in chronic pain, mostly later in life, and probably can also be improved in some cases with a little effort. But it’s not a straightforward business, this posture stuff! There aren’t many “easy wins” for people here. And there’s plenty of potential to waste time and money — or even get hurt. Delving deeper into the topic as a journalist, studying the scientific literature and learning more from countless readers and experts, I have developed many reasonable doubts about posture’s importance.
In pain and forced to use a wheelchair, a young woman opts to amputate her clubfeet. "New prosthetics have made active life possible for many with injuries and congenital defects." [Via]
Grand Unified Theory of Female Pain. "The pain of women turns them into kittens and rabbits and sunsets and sordid red satin goddesses, pales them and bloodies them and starves them, delivers them to death camps and sends locks of their hair to the stars. Men put them on trains and under them. Violence turns them celestial. Age turns them old. We can’t look away. We can’t stop imagining new ways for them to hurt." [more inside]
When you get a headache, you're faced with the Big Three options for over-the-counter pain relief: aspirin, acetaminophen (paracetamol) or ibuprofen. But which is best, according to the latest scientific evidence? And what's the best for toothache, back pain, period pain or musculoskeletal injuries? A pain specialist explains who the winners are in each main category.
Tara Parker-Pope of the New York Times reported on a study from the Annals of Internal Medicine that found chiropractic manipulation to be more effective than medication in relieving acute and subacute neck pain. Light exercise worked too. No adverse effects were reported.
The day pain died. "The date of the first operation under anesthetic, Oct. 16, 1846, ranks among the most iconic in the history of medicine. It was the moment when Boston, and indeed the United States, first emerged as a world-class center of medical innovation. The room at the heart of Massachusetts General Hospital where the operation took place has been known ever since as the Ether Dome, and the word 'anesthesia' itself was coined by the Boston physician and poet Oliver Wendell Holmes to denote the strange new state of suspended consciousness that the city's physicians had witnessed. The news from Boston swept around the world, and it was recognized within weeks as a moment that had changed medicine forever." [Via]
A Medical Madoff: Anesthesiologist Faked Data in 21 Studies. "A pioneering anesthesiologist has been implicated in a massive research fraud that has altered the way millions of patients are treated for pain during and after orthopedic surgeries."
Doctors successfully removed a two-inch nail from a man's genitals yesterday. Doctors pulled the nail out of his urethra on their first attempt and later said the man could have died if the object had not been spotted on X-ray. The man had admitted himself to SMC on Sunday night with extreme abdominal pain and was unable to speak. The man told doctors the last thing he remembered was having something sprayed in his face and being fondled by one of his assailants before he blacked out. [more inside]
Richard Paey Speaks - An interview with the paraplegic man sentenced to 25 years in prison for treating his own pain, but now out after a full pardon by the Florida Governor. [more inside]
Robin Prosser was a former concert pianist and systems analyst who suffered from an autoimmune disease similar to lupus for over 20 years. The disease left her in constant pain and made her allergic to most pharmaceutical painkillers. Only medical marijuana brought her relief, but last spring the DEA seized her medicine. Unable to cope with the chronic pain any longer, she committed suicide on October 18th. [Via Andrew Sullivan.]
Drugs Banned, Many of World’s Poor Suffer in Pain "Millions of people die in pain because they cannot get morphine, which is legal for medical use in most nations." [Via TalkLeft.]
Recognizing Pain Management as a Fundamental Human Right. These pieces from the journal of the International Anesthesia Research Society argue that under-treated chronic pain is becoming a public health crisis which must be addressed. But a warning to pain doctors in the U.S. who prescribe opioids in doses that seem high to narcotics agents and prosecutors: “Be afraid.” [Via Hit & Run and TalkLeft.]
"Doctor, it hurts when I do that." Doctors and patients agree - doctors are lousy when it comes to recognizing, diagnosing and treating pain. The AMA developed this free Continuing Medical Education tool (requires Flash) to help docs learn and understand how to deal with pain - but other folks, folks who are now in pain or might someday be in pain, might find it quite interesting as well. All docs in California have to complete this seminar or a similar one by the end of 2006 to get relicensed; the hope is that this will help the docs and the patients who have to deal with pain on a daily basis.
The Painful Truth. "The Iraq war is a new kind of hell, with more survivors - but more maimed, shattered limbs - than ever. A revolution in battlefield medicine is helping them conquer the pain."
No pain, no gain, they say, and when it comes to real pain, the inverse is true as well. "We now have research indicating there's a memory of chronic pain," said Dr. Doris K. Cope, director of chronic and cancer pain for the University of Pittsburgh Medical Center. It changes the genic code sometimes, it changes the biochemistry, and it causes new proteins to be formed." Or in other words, the more pain you have, the more pain you have. (More on this.) It's no wonder, then, that more money is spent on pain relief than any other medical problem, and that there has been so much pain research and so many clinical trials revealing such painful facts as redheads feel more pain, men feel less pain, and that there's a genetic difference between tough guys and wimps. (Much more pain inside.)