Health and Disability

“We found that chronic pain changes the way DNA is marked not only in the brain but also in T cells, a type of white blood cell essential for immunity”, says Moshe Szyf, a professor in the Faculty of Medicine at McGill. “Our findings highlight the devastating impact of chronic pain on other important parts of the body such as the immune system.”

Chronic pain – pain that lasts six months or more -- is one of the most common causes of disability worldwide. Despite enormous efforts to find new therapeutic strategies, however, effective treatments for chronic pain remain elusive.

"We studied patients with neuropathic pain from nerve injuries such as diabetic neuropathy and pinched nerves, and the ones who weren't prescribed any opioids had statistically lower disability and higher physical functioning scores," says Geoff Bostick, associate professor of physical therapy at the Faculty of Rehabilitation Medicine and lead author of the study published in Pain Medicine.

The study looked at 789 patients across Canada who provided baseline measures of self-reported function, and again at six and 12 months after treatment. Adjusting for severity of the symptoms, the research showed physical functioning and disability did not improve in patients with neuropathic pain who were prescribed opioids compared with those who were not prescribed.

"Even though opioid medications can be a powerful pain killer, it does not necessarily mean improved function will follow--pain is not the only factor in determining function," explains Bostick.

"It can be difficult helping people move when they have pain, but as a physiotherapist I know the importance of physical function and we have to help find a way to promote movement, even if it is painful."

As a pain expert, Bostick understands the important role opioids play in the treatment of pain.

"Pain is very complex, and people experience pain at very different levels. Opioids can help people with severe pain be more comfortable, but if they are not also facilitating improved function, the impact of these medications on quality of life should be questioned."

At Children's in Dallas, there are 10 full-time emergency pharmacists, more than anywhere else in the country, and they are on call 24 hours a day. The pharmacists provide a vital safety net, according to Dr. Rustin Morse, chief quality officer and a pediatric ER physician.

"Every single order I put in," Morse says, "is reviewed in real time by a pharmacist in the emergency department prior to dispensing and administering the medication."

"Women have been telling doctors that their migraine headaches worsen around menopause and now we have proof they were right," says Vincent Martin, MD, professor of internal medicine in UC's Division of General Internal Medicine and co-director of the Headache and Facial Pain Program at the UC Neuroscience Institute.

The risk for high frequency headache, or more than 10 days with headache per month, increased by 60 percent in middle-aged women with migraine during the perimenopause--the transitional period into menopause marked by irregular menstrual cycles--as compared to normally cycling women, says Martin, the study's lead author.

The groups, led by trained facilitators, were focused on providing people with a better understanding of their dementia and ways to cope with it. Participants were supported in their ability to manage their own symptoms, treatment and lifestyle changes with information and expert help. They were then encouraged to share ideas and strategies for dealing with their condition and were encouraged to record notes and reminders in a handbook.

"Developing dementia can be a scary and isolating experience. We developed a group programme to help people with dementia manage their condition and find ways of dealing with the changes in their lifestyle. We found early evidence that empowering people to manage their own symptoms and bringing them together helped them feel more confident about managing everyday life with dementia," said lead researcher Dr Catherine Quinn, Senior Research Fellow in The Centre for Research in Ageing and Cognitive Health (REACH).

"All this has helped to enhance their quality of life. The group members became friends and supported each other, and we found that they benefited from being able to learn from each other."

A group of researchers led by Marcus Schmitt-Egenolf at Umeå University has, in a cohort study, investigated the effects of ageing in terms of access to modern pharmaceuticals in psoriasis healthcare. The study, which is the first of its kind, found that elderly patients have reduced access to the relatively new treatment of psoriasis using biologics. Biologics are medications that either target T-cells or block immune system protein and is more efficient but also more expensive than the corresponding, conventional and systematic treatment. The study shows that the patient's access to this treatment method was reduced with every year of ageing.