Pain medicine : the official journal of the American Academy of Pain Medicine
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Opioids are one of the most commonly prescribed medicines for chronic pain. However, their use for chronic pain has been controversial. The objective of this literature review was to identify the role of genetic polymorphisms on patient treatment parameters (opioid dose requirements, response, and adverse effects) for opioids used in malignant and nonmalignant chronic pain. The opioids that this review focuses on are codeine, morphine, oxycodone, tramadol, and fentanyl. ⋯ Currently, there are few validated studies to form a strong evidence base to support pharmacogenomics testing when initiating opioid therapy. However, the field of pharmacogenomics in chronic pain is likely to expand over the coming years, with the increasing number of treatment options available and larger cohorts being assembled in order to identify true associations.
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Randomized Controlled Trial
Comparison of the Acute Effect of Radial Shock Wave Therapy and Ultrasound Therapy in the Treatment of Plantar Fasciitis: A Randomized Controlled Study.
This study compared the effectiveness of radial extracorporeal shock wave therapy (r-ESWT) with ultrasound (US) therapy in the treatment of plantar fasciitis (PF). ⋯ All groups and particularly the r-ESWT and US groups' symptoms were decreased after treatment. However; FFI parameters were reduced more in the US groups than the other two groups, the ankle proprioception sense increased in the r-ESWT group, and there was no change in the other groups.
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Randomized Controlled Trial
A Phase 2b, Randomized, Double-Blind Placebo-Controlled Study to Evaluate the Efficacy and Safety of Naldemedine for the Treatment of Opioid-Induced Constipation in Patients with Chronic Noncancer Pain.
This study evaluated the efficacy and safety of oral naldemedine 0.1 mg, 0.2 mg, or 0.4 mg once daily in patients who had opioid-induced constipation (OIC) and maintained a stable laxative regimen. ⋯ Naldemedine 0.2 mg once daily is the optimal dose for future confirmatory trials in OIC.
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Animal models have previously shown that HIV is associated with hyperalgesia, or heightened sensitivity to painful stimuli. Efforts to determine whether this finding translates to humans are presently lacking. Among persons living with HIV (PLWH), those with detectable viral loads may be at greatest risk for heightened pain sensitivity. It was hypothesized that PLWH with detectable viral loads would be more sensitive to painful stimuli compared with PLWH without detectable viral loads and healthy controls without HIV. ⋯ These preliminary results tentatively suggest that the detectable presence of the virus may sensitize PLWH to painful mechanical and heat stimuli.
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Not only is persistent pain a debilitating health problem for older adults, it also may have negative effects on family relationships. Studies have documented the effects of pain on spouses and on parents of young children. However, research has not extended this line of inquiry to later life, and specifically to the impact of older parents' pain symptoms on adult children. This study addresses the question: Does older mothers' pain affect the quality of relations with offspring? ⋯ Based on the findings of this article, further exploration of the impact of chronic pain on relations between adult children and their parents is justified. Of interest is exploration of factors that may insulate later-life intergenerational relationships from the effects of pain.