What Non-Opioid Treatment Options are Available for Chronic Pain?
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Robert Hindes, an expert in internal medicine and infectious diseases, discusses non-opioid treatment options for chronic pain. These include over-the-counter medications like ibuprofen and acetaminophen, which are generally not effective enough for long-term chronic pain. Non-drug therapies include electrical stimulation, nerve blocks, and injections of drugs that block or destroy pain fibers, such as capsaicin and resiniferatoxin. Spinal cord stimulation and cryoneurolysis (freezing nerves) can also help reduce chronic pain but tend to be more expensive. Stem cell research may lead to additional non-opioid options in the future.
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2) HEA was as effective as SMT, with no important differences in pain reduction between the two treatments at any time point.
3) Both SMT and HEA were more effective for reducing neck pain than medication in both the short and long term.
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Dry needling
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- It discusses the goals of pain therapy, approaches to patients with pain including classification, measurement scales, and examination.
- Types of pain like nociceptive and neuropathic pain are defined. Analgesic treatments like NSAIDs, opioids, and the WHO pain ladder are explained.
- Management of chronic pain, use of TCAs, anticonvulsants, and opioids are covered. The role of a multidisciplinary team and various modalities are highlighted. Pain in palliative care is also addressed.
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This randomized controlled trial compared the effectiveness of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain. The trial found that:
1) SMT had a statistically significant advantage over medication in reducing pain up to 1 year after treatment based on participant-reported pain levels.
2) HEA was as effective as SMT, with no important differences in pain reduction between the two treatments at any time point.
3) Both SMT and HEA were more effective for reducing neck pain than medication in both the short and long term.
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The document discusses various options for treating pain, including nonopioid analgesics like acetaminophen and NSAIDs which are effective for mild to moderate pain. Opioid analgesics are also discussed as options for moderate to severe pain. Adjuvant drugs like gabapentin, pregabalin, and certain antidepressants can help treat neuropathic pain. Neural blockade techniques like epidural analgesia and neuroablation provide pain relief through interrupting nociceptive pathways. Neuromodulation methods like TENS, spinal cord stimulation, and dorsal root ganglion stimulation may decrease pain through activating endogenous pain modulation.
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Chu et al. (2015)
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- The document provides an overview of pain therapy and clinical aspects presented by Dr. L. S. Patil.
- It discusses the goals of pain therapy, approaches to patients with pain including classification, measurement scales, and examination.
- Types of pain like nociceptive and neuropathic pain are defined. Analgesic treatments like NSAIDs, opioids, and the WHO pain ladder are explained.
- Management of chronic pain, use of TCAs, anticonvulsants, and opioids are covered. The role of a multidisciplinary team and various modalities are highlighted. Pain in palliative care is also addressed.
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Robert Hindes, MD is the chief medical officer of Trek Therapeutics, a company seeking new treatments for hepatitis C virus (HCV). Doctors at Monash University are urging the Australian government to subsidize new direct-acting antiviral drugs that can cure HCV to prevent thousands of avoidable deaths from liver disease. The new drugs work by disrupting HCV replication and infection. Researchers cited the drugs' high cure rates but noted that without subsidies, their high cost puts them out of reach for most patients and could lead to over 22,000 HCV-related deaths in Australia by 2030.
The Co-Infection of HCV and HIV
Dr. Robert Hindes published numerous articles on infectious diseases like hepatitis B and C after completing a research fellowship at Harvard Medical School. The document discusses the co-infection of hepatitis C virus (HCV) and human immunodeficiency virus (HIV), noting that HCV is transmitted through contact with an infected person's blood, often from sharing needles, and this increases the risk of co-infection with HIV. It states that co-infected patients experience accelerated liver disease according to the National Institutes of Health.
American Liver Foundation Rallies Support for Liver Life Walks
Robert Hindes, MD founded Trek Therapeutics in 2014 to develop more affordable treatments for hepatitis C and other infectious diseases. The CDC estimates that over 4 million Americans have chronic hepatitis B or C, which can lead to liver disease, cirrhosis, and cancer. While current antiviral treatments are effective for many patients, barriers to treatment still exist for some. The American Liver Foundation holds annual Liver Life Walks across the country in May and June to raise funds and awareness for hepatitis and other liver diseases.
Research Examines Combination Treatment for Hepatitis C
A study examined the combination of sofosbuvir, ribavirin, and pegylated interferon alfa-2a to treat genotype 1 hepatitis C infection. Researchers divided patients into three cohorts receiving different treatment regimens and found patients tolerated sofosbuvir well over 12 weeks. The study concluded further trials should examine sofosbuvir therapy for people with hepatitis C and cirrhosis.
Sofosbuvir Inhibitor Helps Fight Hepatitis C
Robert Hindes, MD helped develop sofosbuvir, a potent nucleotide analogue, while vice president of clinical development at Pharmasset. Sofosbuvir inhibits HCV polymerase and is currently the most effective drug being tested to treat hepatitis C. After Gilead Sciences acquired Pharmasset, they conducted Phase 3 clinical trials of sofosbuvir alone and in combination with other agents like ribavirin. These combinations resulted in high sustained response rates up to 12 weeks post treatment.
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- 1. What Non-Opioid Treatment Options are Available for Chronic Pain? By: Robert Hindes MD
- 2. What Non-Opioid Treatment Options are Available for Chronic Pain? A graduate of Rutgers Medical School in New Jersey, Robert Hindes holds certifications in internal medicine and infectious diseases. Robert Hindes was co-founder and chief medical officer of Trek Therapeutics; in this role, he led the development of clinical strategy for the company, and supervised all clinical activities, operations, and employees. Most recently, he was Vice President of Clinical Research at Sorrento Therapeutics where he worked on injectable non-opioids for treatment of chronic pain.
- 3. What Non-Opioid Treatment Options are Available for Chronic Pain? Over the counter medications such as ibuprofen, aspirin, and acetaminophen, are less prone to overuse or abuse by chronic pain patients, but are generally not effective enough to provide a long- term solution to chronic pain. Non-opioid pain treatments can also take the form of non-drug therapies--such as the application of electrical signals and/or radio waves, and injections of new types of drugs that selectively block or lyse pain fibers. These drugs include capsaicin and resiniferatoxin (RTX) which can be administered in joints or directly around nerves. Other chronic pain treatments include conventional nerve blocks. While some patients prefer to recover from chronic pain by using medications, other patients prefer non-drug therapies—or the combination of both options. Treatments such as injections and nerve blocks are particularly effective in facilitating patients’ recovery in cases where the prolonged use of medication is not working.
- 4. What Non-Opioid Treatment Options are Available for Chronic Pain? Spinal cord stimulation and cryoneurolysis (freezing affected nerves) are other methods of non- opioid pain reduction that can be effective, but that tend to carry a higher cost. Stem cell research may also lead to the development of new non-opioid treatment options--however, it may take time before these new options are viable.