Pain practice : the official journal of World Institute of Pain
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Chronic pain (CP) affects 35.0%-51.3% of the UK population, with 67%-88% reporting sleep disturbances. Cannabis-based medicinal products (CBMPs) have shown therapeutic potential in managing CP. Evidence suggests poor sleep worsens pain perception; therefore, this study aimed to assess patient-reported outcome measures (PROMs) following CBMP treatment in CP patients with and without co-morbid sleep impairment. ⋯ Whilst these results show promise for the effects of CBMPs on CP, they must be examined within the limitations of the study design. These findings provide further evidence to support the design of subsequent randomized controlled trials to verify causality between CBMPs and pain outcomes.
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Pain management in patients with complete spinal cord injury is complex. ⋯ The effectiveness of this approach may be attributed to its ability to modulate supraspinal pain processing, allowing for targeted relief of various pain mechanisms below the level of injury.
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Although long-term opioid therapy (LTOT) for chronic pain has declined, it remains common in the U.S. Providers do not have clinical practice guidelines for vulnerable LTOT patients, in whom both LTOT continuation and tapering to discontinuation pose risks of harm and in whom opioid use disorder (OUD) is absent. ⋯ Evidence is needed to build on and test these experts' recommendations to attempt tapering and add non-opioid pain therapies for patients reporting harms of continued LTOT who may experience harms from tapering. Such evidence informs the development of clinical practice guidelines that provide comprehensive protocols to support the safety and functioning of this group of patients.
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The fields of anesthesiology and pain medicine are experiencing significant changes driven by market forces and professional preferences. While demand for anesthesiologists is rising, pain medicine is facing a decline in fellowship applications. ⋯ The decline in pain medicine fellowship applications, particularly among anesthesiology residents, signals potential future workforce shortages and challenges in patient care. Recruitment strategies should include early exposure to pain medicine during residency, enhanced mentorship programs, and robust recruitment efforts (including virtual options). Addressing these issues is essential to ensure enough trained specialists to meet the growing need for pain specialists nationally.
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Community reintegration is an important goal for people living with a spinal cord injury (SCI), and pain is suspected to limit reintegration due to its limitations in daily functioning, mood, and sleep. ⋯ It is not the mere presence of pain that influences community reintegration, but rather the severity and the location of pain. Shoulder care and pain management need to be included in the rehabilitation program, as these are important considerations when rehabilitating people with SCI back into their communities.