In The News: October 2010
Scientists Uncover Substance That Causes Pain, Inflammation
Our bodies produce a substance similar to capsaicin—the ingredient that makes chili peppers hot—at sites of pain, and blocking production of this substance can ease pain, a new study shows. In laboratory work with mice, scientists at the University of Texas Health Science Center discovered that a family of fatty acids called oxidized linoleic acid metabolites (OLAMs) play a significant role in the biology of pain. Blocking either the production or action of these substances, say researchers, could lead to new therapies for various inflammatory diseases and pain disorders, such as arthritis and fibromyalgia. The study’s authors called their findings significant because they not only offer physicians and patients more options in prescribing pain medications but they may also help in the development of analgesics that circumvent the problem of pain-medication dependency and addiction. The study appeared in a recent issue of the Journal of Clinical Investigation.
Early Surgery No More Effective than Other Treatments for Shoulder Repair
Injury to the rotator cuff, a common ailment among older adults, is treatable—but whether surgery or non-surgical treatment is best is unclear. According to a report in the Annals of Internal Medicine, researchers at the University of Alberta examined a variety of treatment options and found that all interventions, either surgical or nonsurgical, result in improvement. Most patients who suffer a rotator-cuff tear are first treated with up to three months of nonsurgical treatment, such as pain and anti-inflammatory drugs, exercise, and rest. If these treatments don’t work, surgical repair is often recommended. Some doctors believe that earlier surgery results in less pain and better use of the shoulder, so patients often face the difficult decision of opting for surgery rather than waiting for non-operative treatments to work. However, authors of the study found little evidence that earlier surgery benefits patients.
Diagnostic Guidelines Seen as Barrier to Back-Pain Relief
Following long-held guidelines for diagnosing the cause of arthritis-related back pain often results in excessive tests, delays in pain relief, and wasteful spending. So suggests new research at Johns Hopkins University School of Medicine. The study, published in the journal Anesthesiology,says a wiser course is to skip diagnostic nerve blocks, used to prove an arthritis connection, and move straight to radiofrequency denervation (RFD), in which heat is used to cauterize small sensory nerves around the spinal joints that cause back pain. (RFD is one of the most common procedures used in U.S. pain clinics, and relief can last several months and sometimes years.) Researchers divided 151 patients with arthritic back pain into three groups: Group 1 received RFD without nerve blocks; Groups 2 and 3 underwent RFD only after one or two nerve blocks. One-third of the patients in Group 1 experienced significant pain relief lasting at least three months, while just 16 percent in Group 2 and 22 percent in Group 3 improved. The results led researchers to conclude that patients often endure long delays and multiple procedures before getting lasting pain relief, noting that making diagnostic accuracy a higher priority than pain relief may be misguided. They further noted that although RFD is unlikely to help patients whose back pain is not caused by arthritis, the procedure is not dangerous for those without arthritis.
TNF Drugs May Increase Risk of Skin Cancer
Check your skin regularly if you take a tumor necrosis factor (TNF) blocker to relieve rheumatoid arthritis (RA) pain. Data from a British RA registry suggest that taking a TNF blocking drug—adalimumab, etanercept, infliximab, golimumab, certolizumab pegol—increased the risk of developing a non-melanoma skin lesion by 70 percent compared with treatment with a traditional disease-modifying antirheumatic drug (DMARD). Despite the risk, Dr. Kimme Hyrich of Manchester University and lead author of the study concluded that the benefits of TNF blockers for RA patients far outweigh the observed risks, adding that "overall, the risk of skin cancers in the bigger picture remains low."