Pain Management Commons^™

Biopsychosocial Management Of Long Covid Fibromyalgia: Lessons From The Penn Medicine Lancaster General Health Fibromyalgia Program, Joseph Harrison, Dennis Given Psy.D.

The Journal of Integrated Primary Care

The COVID-19 pandemic has increased the prevalence of chronic health concerns worldwide, leading to a new population of patients suffering from Long Covid. Patients with Long Covid often experience persistent symptoms impacting multiple organ systems, including neuroimmune and neurological manifestations. Recently, attention has grown toward Long Covid patients developing chronic widespread pain similar to fibromyalgia. Fibromyalgia is a nociplastic pain disorder characterized by widespread pain and central sensitization with fatigue, sleep disturbances, and impairments in cognitive functioning. Given the nascent and limited research exploring new treatment options, patients need support now from biopsychosocial multi-modal pain management strategies. The Fibromyalgia Program …

Quality Improvement Protocol: Improving The Use Of Nonpharmacological Pain Management Strategies Within The Inpatient Hospital Setting, Katherine Salamon, Christina Russell, Dara Devinney, Catherine M Soprano

Department of Medicine Faculty Papers

Background: There are many nonpharmacological pain management services available to hospitalized youth; however, not all youth are offered these services. Lack of knowledge about resources, difficulty with the referral process, and lack of understanding about nonpharmacological pain management services and when to refer patients are among the main reasons for lack of utilization. Quality improvement (QI) initiatives have grown within hospital settings and can serve to create change in fast-paced environments. Methods: The current QI project aimed to pilot an educational program to increase the use of nonpharmacological pain management interventions. Staff located on one floor of a pediatric hospital …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

Drug-Free Noninvasive Thermal Nerve Block: Validation Of Sham Devices, Michael Fishman, Ahish Chitneni, Alaa Abd-Elsayed, Samuel Grodofsky, Ashley Scherer, Brendan Schetzner, Malvina Klusek, Stephen Popielarski, Stephen Meloni, Steven Falowski, Philip Kim, Konstantin Slavin, Stephen Silberstein

Department of Jefferson Headache Center papers and presentations

Headache is a leading cause of disability and suffering. One major challenge in developing device treatments is demonstrating their efficacy given devices' often-high placebo rate. This paper reviews the importance of validating sham devices as part of finalizing the design for larger-scale prospective randomized controlled trials in patients with chronic headache as well as the results of a prospective, single-blind trial to validate two potential sham noninvasive thermal nerve block devices. Study participants were trained to self-administer thermal nerve block treatment using sham devices in an office visit. Two different sham systems with different temperature profiles were assessed. Devices were …

Do Group Medical Visits With A Focus On Mind And Body Help Patients With Chronic Pain And Symptoms Of Depression?, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Health centers can use the results when considering how to help patients with chronic pain and depression reduce their use of pain medicines.

The Meaning Of A Choice, Julie-Louise Zeitoun

Masters Theses

If you are disabled or disadvantaged, you will be dismissed and stifled. Few people will actively care for your struggles. As a person with autism, I was deeply fearful of the persecution I had faced throughout my life; it was a fear that followed me with terrifying determination. I desperately wanted to blend into society. So I designed myself to be devoid of any weakness, and productivity was the way I chose to conceal any difficulties I faced. It was a way to measure my success — a way to measure my normalcy.

Standard medical textiles are generic, cumbersome devices. …

Bridging Empathy, Qianwen Lu

Masters Theses

As a jeweler, ally, and sympathetic witness to the traumatic stories of survivors, my work aims to support the process of reconstruction and reintegration for victims and the greater community. To move beyond isolation, resentment, and debilitating helplessness requires care and support. I want my jewelry to act as catalysts in the healing process by straddling both sides of the trauma-induced situation, to create greater awareness and empathy. National Coalition Against Domestic Violence shows that women are more likely to become victims of domestic violence, sexual assault, or other forms of physical and psychological abuse in unhealthy emotional relationships. These …

Examining The Use Of Expressive Arts Therapies In Neurorehabilitation Treatment Planning, Rebecca J. Horner

Expressive Therapies Capstone Theses

Those undergoing neurorehabilitation after stroke and traumatic brain injury report a diminished sense of overall wellness. This paper examines the conceivable benefits of introducing expressive arts therapies, which is the therapeutic use and combination of the visual arts, movement, drama, music, writing and other intermodal creative processes, into physical therapy and neurorehabilitation treatment planning. Expressive arts therapies have the capacity to engage with an individual’s physical, emotional, social and spiritual states concurrently. They simultaneously offer the ability to promote an increased sense of well-being, address mind-body disconnects, and process trauma non-verbally.

The sections of this narrative literature review focus on …

Du Undergraduate Showcase: Research, Scholarship, And Creative Works, Caitlyn Aldersea, Justin Bravo, Sam Allen, Anna Block, Connor Block, Emma Buechler, Maria De Los Angeles Bustillos, Arianna Carlson, William Christensen, Olivia Kachulis, Noah Craver, Kate Dillon, Muskan Fatima, Angel Fernandes, Emma Finch, Colleen Cassidy, Amy Fishman, Andrea Francis, Stacia Fritz, Simran Gill, Emma Gries, Rylie Hansen, Shannon Powers, Jacqueline Martinez, Zachary Harker, Ashley Hasty, Mykaela Tanino-Springsteen, Kathleen Hopps, Adelaide Kerenick, Colin Kleckner, Ci Koehring, Elijah Kruger, Braden Krumholz, Maddie Leake, Lyneé Alves, Seraphina Loukas, Yatzari Lozano Vazquez, Haley Maki, Emily Martinez, Sierra Mckinney, Mykaela Tanino-Springsteen, Audrey Mitchell, Kipling Newman, Audrey Ng, Megan Lucyshyn, Andrew Nguyen, Stevie Ostman, Casandra Pearson, Alexandra Penney, Julia Gielczynski, Tyler Ball, Anna Rini, Christina Rorres, Simon Ruland, Helayna Schafer, Emma Sellers, Sarah Schuller, Claire Shaver, Kevin Summers, Isabella Shaw, Madison Sinar, Claudia Pena, Apshara Siwakoti, Carter Sorensen, Madi Sousa, Anna Sparling, Alexandra Revier, Brandon Thierry, Dylan Tyree, Maggie Williams, Lauren Wols

DU Undergraduate Research Journal Archive

DU Undergraduate Showcase: Research, Scholarship, and Creative Works

End Of Life Symptom Management In The Emergency Department, Alice Chang, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

The Emergency Department is at times the only place patients can turn to for symptom relief. In an aging population, this means that more patients are presenting to the ED towards the end of life (EOL). Emergency medicine (EM) prides itself as a specialty that handles disease-directed treatment for a variety of acute conditions. In contrast, palliative care (PC) is focused on improving the quality of life (QOL). It has become essential for EM physicians to care for patients who are not seeking life-sustaining measures, but instead quality of life interventions. Patients with serious illness, even hospice patients, present to …

Inpatient Opioid Use Varies By Construct Length Among Laminoplasty Versus Laminectomy And Fusion Patients, Harry M. Lightsey, Peter J. Georgakas, Matthew H. Lindsey, Caleb M. Yeung, Joseph H. Schwab, Harold A. Fogel, Stuart H. Hershman, Daniel G. Tobert, Kevin M. Hwang

Rothman Institute Faculty Papers

BACKGROUND: Laminoplasty (LP) and laminectomy and fusion (LF) are utilized to achieve decompression in patients with symptomatic degenerative cervical myelopathy (DCM). Comparative analyses aimed at determining outcomes and clarifying indications between these procedures represent an area of active research. Accordingly, we sought to compare inpatient opioid use between LP and LF patients and to determine if opioid use correlated with length of stay.

METHODS: Sociodemographic information, surgical and hospitalization data, and medication administration records were abstracted for patients >18 years of age who underwent LP or LF for DCM in the Mass General Brigham (MGB) health system between 2017 and …

Pne - Lots Of Talk, Superficial Results, Aidan Keller, Michael Ray, Taylor Baugher

ASPIRE 2023

A narrative review (NR) of meta-analyses (MA) and systematic reviews (SR) that assess the effectiveness or efficacy of pain neuroscience education (PNE) on various outcome measures in individuals with chronic musculoskeletal (MSK) pain. Systematic searches were conducted on 4 databases. Study selection included MAs and SRs that assessed the effectiveness or efficacy of PNE on CP populations. Quantitative eligibility criteria included randomized controlled trials (RCTs), adults (18+ years of age), English or Spanish speaking individuals, and reporting of chronic pain (persistent or recurrent pain lasting ≥ 3 months). Qualitative eligibility criteria included individuals reporting chronic pain and experienced a PNE …

The Influence Of Genetics, Insulin Resistance, Oxidative Stress, And Energy Deficit On Migraine, Victoria Dm Maldonado Llinas

Honors Undergraduate Theses

The pathomechanism of migraine attacks is not understood well, however, is currently believed to be a brain disorder. Migraine is a multifactorial disorder that needs to be investigated in multiple research areas to shed light into its mechanism and find ways to treat it effectively. Migraine episodes come from one or many things at the same time, and such vary from person to person. However, sufficient evidence in recent studies show there is a strong relationship between genetics with patients having specific genes that may be responsible for the disease or a genetic sequence passed down through generations in families, …

Mental Health Stigma In South Asians With Crohn’S Disease, Bansi Patel

Scripps Senior Theses

Chronically ill individuals often face comorbid mental illnesses. Mental illness symptoms can cause their chronic illness symptoms to worsen; the converse is also true. Such is the case with Crohn’s disease (CD) patients. The present literature lacks research on the relationship between CD and mental illness symptoms. Additionally, the literature lacks chronically ill participants who are South Asian Americans (SAA). SAA often face more mental health stigma than their white peers which can worsen one’s mental illness symptoms. This study examines the impact that mental health symptoms have on the psychological distress faced by SAA who are diagnosed with CD. …

Efficacy Of Adapted Mindfulness-Based Stress Reduction Program In Treating Patients With Mild Traumatic Brain Injury, Kate Whipple

Scripps Senior Theses

Mindfulness-based stress reduction (MBSR) has been applied in many contexts, and has been found to be a helpful therapeutic intervention for people dealing with both mental and physical struggles. In recent years, studies exploring the effects of using MBSR in the neurorehabilitation people with traumatic brain injuries (TBIs) have emerged. However, these studies are primarily pilot studies with very few participants. This proposed study will explore whether an adapted version of the MBSR program is effective in reducing apathy and improving motivation to recover in participants with mild TBIs (mTBIs). The proposed study will have 76 participants and will uses …

The Effectiveness Of Laser Acupuncture In Pain Management: A Systematic Review, June Park

Theses and Graduate Projects

Background: Pain is a common symptom across many medical conditions that patients experience. Pain management is complex and may need a combination of several management techniques. Laser acupuncture(LA) has been previously used as an adjunct to conventional pain treatments.

Objective: This systematic review aims to evaluate the effectiveness of laser acupuncture in various fields of medical situations such as chronic pain, low back pain, osteoarthritis, osteoporosis, postoperative pain and dental procedures.

Methods: A computer based literature search of databases through GoogleScholar and PubMed was used to identify randomized controlled trials(RCTs) published after 2018 that studied the effect of LA in …

Altop (Alternatives To Opioids), Fall 2022, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

In this issue:

• New Principal Investigator (PI) ALTOP Grant
• 2021-2022 Graduating Class
• ANEW HRSA 2022-2023 Awardees
• Students Quality Improvement Projects
• April 9th, 2022, Preceptor Workshop Photos
• New Clinical Partner: The Bridgeport Rescue Mission/ Sage Health Care
• Save the Date: Annual DNP Colloquium

How To Survive College As An Acoa: The Effectiveness Of University Resources On Helping Acoas Socially And Psychologically Succeed During Their Academic Career, Kelly Buchan

Senior Theses

In 2019, 14.5 million people ages 12 and older had Alcohol Use Disorder (AUD), but only 10% received treatment (National Institute on Alcohol Abuse and Alcoholism [NIAAA], 2022). Parental drinking problems can directly affect children, or “Adult Children of Alcoholics.” Of the few studies targeting ACoAs, results show that ACoAs not only have higher risks of mental illness, but they also have lower GPAs and social health (Schroeder & Kelley, 2008). Thus, this study assessed the extent to which perceptions of the college drinking environment are related to higher depression rates in ACoAs, certain drinking motivations, and reluctance to use …

Thoughts, Feelings, Actions; The Brevity Of Being: A Haiku Method, Scott Medeiros

Expressive Therapies Capstone Theses

The difficulties of delivering clinical services during the pandemic showed that there was a need for interventions that were able to be adapted to virtual sessions. In addition, lack of training and expertise regarding specialized therapies require modern day clinicians to be able to synergize current theory with the reality of the mental health landscape. In this study, 19 individuals participated in a psychoeducation group that taught a therapeutic thought mapping technique that was then adapted towards the creation of a haiku. It was noticed that participants were able to learn a psychological concept, apply it towards their life, create …

Enhancing Physician Perspectives Of Skilled Occupational Therapy Services For Patients With Rheumatoid Arthritis, Valerie S. Trinidad

Department of Occupational Therapy Entry-Level Capstone Projects

This Capstone Project, with a focus in research, sought to identify a relationship between self-reported functional performance and participation restriction as described by satisfaction with one’s execution or participation in a described occupation. A correlational study design was employed under the mentorship of Dr. Thomas Decker, EdD, OTD, OTR/L who oversaw all IRB processes, documentation, study development and deployment, as well as co-authored and provided mentorship for creation of a publishable manuscript of this project. The established Health Assessment Questionnaire Disability Index (HAQ-DI) and the newer Keele Assessment of Participation (KAP) were the two outcome measures of focus for surveying …

Utilizing Primary Care To Engage Patients On Opioids In A Psychological Intervention For Chronic Pain, Sikander Chohan, Lyuba Gavrilova Bs, Leah Hect, Kristi Autio, Erin Tobin, Brian K. Ahmedani, Lisa R. Miller-Matero

Medical Student Research Symposium

Introduction: Chronic pain is commonly encountered in primary care. It is often treated with opioids, which can cause overdose and death. Psychological interventions are an effective alternative, yet difficulty engaging patients with opioid prescriptions has led to their underutilization. Offering these interventions in primary care settings may alleviate this barrier.

Objective: Determine whether opioid prescriptions are related to patients engaging in a brief psychological intervention for chronic pain management in primary care.

Study Design: Secondary analysis of a pilot randomized clinical trial (RCT) of a 5-session psychological intervention for chronic pain. Patients with chronic pain (N= 220) were approached to …

Early Integration Of Palliative Care With Curative Oncology Treatment For Patients With Advanced Cancer: Implications For Clinical Nursing Practice, Rhea Rughani

Honors Projects

Palliative care, though clinically established to improve health-related quality of life measures for patients with advanced illness, remains underutilized and largely limited to end of life care. This project aims to inform oncology nursing practice through the analysis of literature supporting the early integration of palliative care with standard curative oncology treatment for patients with clinically advanced cancer. Informed by relevant research, clinical practice guidelines, and improved specialty palliative care training, oncology nurses and nurse practitioners are ideally situated to advocate for and initiate early palliative care integration, to holistically improve the standard approach to complex cancer care.

Physical Activity As A Means Of Improving Quality Of Life In Individuals With Chronic Pain, Tracy Tauro

Rowan-Virtua Research Day

Pharmacologic management of chronic pain has variable results, sometimes resorting to ineffective and dangerous opioids that can potentiate substance abuse in a vulnerable population.

Exercise is unique in its ability to positively impact both the molecular and psychological aspects of chronic pain. Its role in decreasing inflammation as well as improving mental health make it an excellent option for improving quality of life.

Physicians should work with their patients to develop a patient-centered exercise plan to manage chronic pain.

The Occupational Therapy Approach To Pain Treatment: A Pain Curriculum, Rosalee Howell

UNLV Theses, Dissertations, Professional Papers, and Capstones

It is within the scope of the occupational therapy profession to treat patients experiencing pain. The holistic approach used to assess and treat patients to improve functional performance is vital in treating pain. The focus is to decrease the detrimental impact of pain on the patient’s mental health, enhancing their ability to function in social and vocational roles. However, education is not adequately addressed in occupational therapy programs and is vital in preparing clinicians to meet the patient’s needs effectively.

This Doctoral Capstone was developed to highlight the importance and the benefit of education in preparing clinicians to treat patients …

Implementation Of A Self-Management Program For Hispanic Patients With Chronic Non-Cancer Pain, Genesis M. Ladinez Velez

DNP Projects

Background: Chronic non-cancer pain (CNCP) is a major public health issue that affects over 100 million Americans. From January 2019 to September 2021, the number patients seen at a Federally Qualified Health Center (FQHC) was 41, 974 of these 40.12% were Hispanic. Of the total patient population at this FQHC, 904 patients had preexisting opioids prescriptions for CNCP. The Hispanic population represents 41.15% of the preexisting prescriptions. Nonopioid alternatives to manage CNCP have been shown to decrease pain and improve functioning similarly to opioids.

Purpose: To implement a CNCP SMP at a FQHC in the Northeast. This quality improvement …

Pain Assessment Policy Update And Nursing Education On Best Practices For Pain Assessment: A Quality Improvement Project, Jennifer Zhang

DNP Projects

Significance and Background: Chronic pain assessment should focus on patients' functional status, quality of life (QOL), and pain control. A tool to assess pain intensity and biopsychosocial impacts of pain for patients with chronic pain was needed in a Federally Qualified Health Center (FQHC). The Defense and Veterans Pain Rating Scale (DVPRS) incorporates a numeric rating scale with four functional questions on pain interference on ADLs. DVPRS design stimulates communication between patients and providers about their pain, its impact on function, and state of mind. Treatments are focused on making the pain tolerable and optimizing patient function while avoiding unwanted …

Barriers To The Use Of Palliative And Hospice Care Among The Latino Population, Diana Ramirez

Electronic Theses, Projects, and Dissertations

Patients suffering from irreversible and terminal illnesses may benefit from the services provided by Palliative and Hospice Care to control any symptom burden and assist in navigating complex medical decisions. Many patients may express hesitation in accepting and enrolling to this service due to misconceptions. Language barriers may add an additional layer of complexity. This study explored the challenges Palliative Care providers encounter when introducing concept of hospice to Spanish-speaking patients their families for the first time. This study implemented qualitative research methods by using semi-structured one-on-one interviews. Ten members of an In-patient Palliative Care Team at a University Hospital …

Critical Appraisal Bibliography, Scientific Abstract, And Matrix/Evidence Table, Nicolas Fuller, Jerry Lunsford, Hayley Robinson

Epsilon Sigma at-Large Research Conference

Introduction and Background

As chronic and acute pain disorders continue to be diagnosed in the clinical setting, the number of patients searching for medical care in hopes of alleviating their symptoms is on the rise. Working in both medical and psychiatric facilities as a certified nursing assistant, I saw opioids frequently prescribed as a pharmacological treatment for individuals looking to lessen the pain associated with a multitude of pain related disorders. Working in long term care facilities, I watched individuals who had never struggled with substance use disorders develop clinical dependencies on narcotic medication due to the fact that they …

Decompression And Interlaminar Stabilization For Lumbar Spinal Stenosis: A Cohort Study And Two-Dimensional Operative Video, Olivia E. Gilbert, Sarah E. Lawhon, Twila L. Gaston, Jared M. Robichaux, Gabriel Claudiu Tender

School of Medicine Faculty Publications

Background and Objectives: Lumbar spinal stenosis is one of the most common causes of disability in the elderly and often necessitates surgical intervention in patients over the age of 65. Our study aimed to evaluate the clinical efficacy of interlaminar stabilization following decompressive laminectomy in patients with lumbar stenosis without instability. Materials and Methods: Twenty patients with lumbar stenosis underwent decompressive laminectomy and interlaminar stabilization at our academic institution. Clinical outcomes were measured using the visual analog scale (VAS) and Oswestry disability index (ODI) at the 2-month, 6-month, and 1-year postoperative visits, and these outcomes were compared to the preoperative …

Targeted Osmotic Lysis: A Novel Approach To Targeted Cancer Therapies, Harry J. Gould, Dennis Paul

School of Medicine Faculty Publications

The conventional treatment of cancer has been based on the delivery of non-selective toxins and/or ionizing energy that affect both the cancer and normal tissues in the hope of destroying the offending disease before killing the patient. Unfortunately, resistance often develops to these treatments and patients experience severe, dose-limiting adverse effects that reduce treatment efficacy and compromise quality of life. Recent advances in our knowledge of the biology of tumor cells and their microenvironment, the recognition of surface proteins that are unique to specific cancers and essential to cell growth and survival and signaling pathways associate with invasion and metastasis …