Pain Management



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Department of Veterans Affairs (VA)

Post-Menopausal Veterans Frequently Prescribed Long-term Opioid Therapy

The VA has focused on reducing the risk of opioid abuse and addiction by issuing guidance that strongly recommends against the use of the painkillers for chronic pain since the implementation of the Opioid Safety Initiative in 2013.

Late Breaking News

Procedure Determines How Long Post-Surgical Patients Should Receive Opioids

Study Uses MHS Data to Create Guidelines for Painkillers BOSTON – How long should patients use opioids after common surgical procedures? Until now, there hasn’t been much consensus on the answer. A new study analyzing... View Article

Late Breaking News

Be Aware of New Clinical Recommendations on Diabetes, Back Pain, PTSD, Amputation, Opioids

Diabetes Guidelines Don’t Include Specific Pharmacotherapy Advise By Annette M. Boyle WASHINGTON —The VA and DoD Evidence-Based Practice Work Group has recently released five updated clinical practice guidelines. They cover common conditions such as Type... View Article

Agencies Home

Navy Functional Restoration Pain Program Shows Success

Chronic pain is the leading cause of medical discharge from active duty military service. Disability payments related to the condition also are a significant economic cost to the DoD.

Agencies Home

Spinal Manipulation Modestly Effective for Low-Back Pain

Spinal manipulative therapy (SMT) is a treatment option for acute low-back pain, but randomized clinical trials (RCTs) and meta-analyses have reported different conclusions about its effectiveness, according to a new study.

April 2017

Pain Continuity, Not Headache Type, Affects Return to Duty

FORT BRAGG, NC — Headaches and how to manage the pain are difficult issues for soldiers who suffered mild traumatic brain injury during the wars in Afghanistan and Iraq and their care providers.

April 2017

Why Opioids Are Discontinued in VHA Patients

PORTLAND, OR—Discontinuation of opioids can be accelerated for several reasons, according to a new study, including lack of information about the long-term effectiveness of opioids for chronic pain, heightened awareness about opioid-related adverse events, closer monitoring of patients for opioid-related aberrant behaviors, and greater restrictions around opioid prescribing.

Agencies Home

Opioid Use Generally Moderate in OEF, OIF, OND Veterans

LITTLE ROCK, AR — With continuing concern about opioid use in veterans, especially those serving in Afghanistan (OEF) and Iraq (OIF and OND), a new study provided a detailed analysis of the issue.

Department of Veterans Affairs (VA)

Opioid Safety Initiative Drives Down Prescriptions for High-Dose Painkillers

Thanks to a national initiative begun at the VHA in 2013, fewer veterans are receiving prescriptions for risky dosages of opioid painkillers.

Battlefield Medicine

Younger Veterans Much More Likely to Suffer Severe Pain Than Nonveterans

Veterans, especially those serving in Iraq and Afghanistan, are about 40% more likely to experience severe pain than nonveterans, according to a new study.

Addiction

Veterans Who Abuse Non-Medical Opioids Have High Risk of Using Heroin

Veterans who misuse opioid painkillers have a very high risk of also beginning to use heroin, according to a new study.

Department of Veterans Affairs (VA)

Pain Levels Improve in Most VA-Treated Veterans As They Age

Time is said to heal all wounds, and that might also be the case with older military veterans suffering from pain.

Addiction

White House Action Increases Opioid Prescription Monitoring at VA

By Annette M. Boyle WASHINGTON—The White House’s announcement this summer of new steps to address the prescription opioid and heroin epidemic had a mixed message for the VA: While the administration specifically praised the VA’s... View Article

Addiction

VA Explores Pain Management Alternatives to Delay Opioid Use

By Annette M. Boyle WASHINGTON—Since the rollout of the VA’s Opioid Safety Initiative in 2014, the department has aggressively focused on developing non-narcotic alternatives to reduce opioid use for chronic pain. Now, attention is turning... View Article

August 2016

Inferior VA End-of-Life Care Reported for Some Noncancer Conditions

Although most patients in the United States die of another condition, cancer is the focus of most end-of-life care studies.

Current Issue

Mindfulness Meditation Helps Veterans Control Pain

WASHINGTON — Pain is recognized as a significant health issue among the approximately 2.6 million servicemembers who have served in Operation Enduring Freedom and Operation Iraqi Freedom.

Department of Veterans Affairs (VA)

Gabapentin Not Effective for Chronic Low Back Pain

SAN DIEGO — The pain medication gabapentin appears to be no more effective than placebo at treating chronic low back pain, according to a study led by the VA San Diego Healthcare System.

Clinical Topics Home

Cryoablation Promising for Phantom Limb Pain

ATLANTA — Military veterans wounded in combat, as well as patients with complex medical conditions, such as uncontrolled diabetes, make up a significant portion of those grappling with pain that seems to appear from an amputated limb.

May 2016

Swedish Massage Improves Pain in Veterans With Knee OA

DURHAM, NC — Swedish massage appears to be a helpful option for VA patients with osteoarthritis of the knee.That’s according to  a study published in the Journal of Alternative and Complementary Medicine. It found that... View Article

February 2016

Early PT Reduces Costs in Military Low Back Pain

SAN ANTONIO — Early, guideline-adherent physical therapy following an initial episode of acute, nonspecific low back pain (LBP) resulted in substantially lower costs and reduced use of healthcare resources over a two-year period.That’s according to... View Article

February 2016

How Effective Is Nicotine for Post-Operative Pain?

PORTLAND, OR — With acute pain a frequent problem after surgical procedures, nicotine has been explored as an adjunctive medication for management of postoperative pain.A research analysis published in the Cochrane Database of Systematic Reviews... View Article

February 2016

Long-Term Opioid Use Increases Depression Risk

LOUIS — While opioids can cause short-term improvement in mood as patients experience pain relief, long-term use of the drugs increases risk of new-onset depression, according to a new study.The research, published recently in the... View Article

Agencies Home

Caution Urged in Prescribing Benzodiazepines to Veterans Using Opioids

Researchers are urging VA clinicians to be cautious about prescribing benzodiazepines to veterans already taking opioid painkillers. That’s in light of a new study, published online recently by the British Medical Journal, finding that nearly half of all veterans who died from drug overdoses while on opioids were also receiving higher doses of benzodiazepines, often used for anxiety, insomnia or alcohol withdrawal.

Agencies

Early Physical Therapy Reduces Back Pain Costs

SAN ANTONIO — Following an initial episode of acute, nonspecific low-back pain (LBP), early and guideline-adherent physical therapy resulted in substantially lower costs and reduced use of healthcare resources over a two-year period, according to... View Article

Agencies

Duration of Opioid Action Affects Unintentional Overdoses

BOSTON — Clinicians weighing the risks and benefits of prescribing different opioid regimens should take not only the daily dose into consideration but also the duration of the opioid action, according to a new study.That... View Article

February 2015

Opioid Prescribing Showed Great Variance Across VHA

IOWA CITY, IA – Opioid prescribing dramatically increased at the VHA during an eight year period ending in 2012 but demonstrated wide variation in prevalence and incident rates across geographical region, sex and age groups.... View Article

February 2015

How Medical Marijuana Laws Affect Opioid Mortality

PHILADELPHIA – Could wider use of medical marijuana reduce mortality from opioid analgesic overdose? That question is raised by a study published recently in JAMA Internal Medicine.1 Noting that opioid analgesic overdose mortality continues to rise... View Article

Clinical Topics Home

Direct Visual Observation Therapy Relieves Phantom-Limb Pain

BETHESDA, MD – With as many as one-third of unilateral=limb amputees suffering regularly from phantom limb pain, military medicine has been in search of an inexpensive and effective treatment. A study published recently in the... View Article

Anesthesiology

Pain Is a Growing Issue for Troops and Veterans; Safer Remedies Sought

WASHINGTON - Trauma-related pain – both acute and chronic -- has always been a universal problem among war-injured troops.

Agencies Home

Telecare Program Effectively Manages Pain, Reduces Opioid Use in VA Patients

By Brenda L. Mooney INDIANAPOLIS  –  A yearlong VA telecare program to manage chronic pain due to arthritis or other musculoskeletal disorders not only doubled the likelihood of improvement for veterans in the intervention program... View Article

Addiction

Research Finds Unexpectedly High Rates of Pain, Opioid Use in Recently Deployed Soldiers

By Annette M. Boyle SILVER SPRING, MD – Skyrocketing prescription opioid use in the civilian population has attracted widespread medical and media attention. While the DoD and VA implemented a pain management task force in... View Article

2014 Issues

FDA Adds Warning to Corticosteroid Injection Labels

WASHINGTON – Corticosteroid injections given to treat neck and back pain, as well as radiating pain in the arms and legs, can have rare but serious adverse effects, according to the Food and Drug Administration... View Article

2014 Issues

Greater Alternative Therapy Use Gradually Decreases Opioid Dependence in Military

WASHINGTON - The use of opioids has slightly decreased in the military, an Army official told lawmakers last month.

2014 Issues

Chronic Pain Med Use Increases Depression Incidence

ST. LOUIS – Chronic use of pain-relieving medication can increase in the risk of developing major depression, according to a new veterans study. The study, led by researchers from Saint Louis University and published recently... View Article

2014 Issues

Mindfulness Intervention Shown to Lower Opioid Misuse

SALT LAKE CITY – Active-duty servicemembers with chronic pain will be among the next groups tested with a new mindfulness-focused treatment to lower opioid misuse. The new intervention, called Mindfulness-Oriented Recovery Enhancement (MORE) is designed... View Article

2014 Issues

Risk, Not Pain Relief, Increased by Pre-Nerve Block Sedation

BALTIMORE – When patients are sedated before a nerve block to diagnose or treat chronic pain, costs and the risks of unnecessary surgery increase without improving patient satisfaction or pain control in the long term.... View Article

2014 Issues

Auricular Acupuncture: Convenient Technique for Battlefield Pain

JOINT BASE ANDREWS, MD - For many servicemembers, pain is an accepted consequence of military service.

2014 Issues

New VA Initiative Seeks to Reduce Opioid Use

MINNEAPOLIS — A new initiative to reduce the use of opioids at the VA already is demonstrating some success at eight launch sites in Minnesota, where high-dose use of the painkillers has been reduced more than 50%.

2014 Issues

Internet Tool Uses Patient Feedback to Improve Army Pain Management

By Sandra Basu WASHINGTON — A new Internet tool is a powerful weapon to combat pain, and the DoD is now launching it in a pilot location. The Pain Assessment Screening Tool and Outcomes Registry... View Article

2014 Issues

How Prescribers Discuss Opioid Use/Abuse with Patients

INDIANAPOLIS — From press reports, it might seem that everyone is talking about opioid analgesics. The question that VA researchers set out to answer, however, is how prescribers were discussing use of the pain relievers... View Article

2014 Issues

Opioid Use Raises Depression Risk in Veterans

ST. LOUIS, MO — The chronic use of opioid analgesics is linked to an increase in the risk of developing major depression, according to a review of veterans’ medical records. The study, led by Saint... View Article

2014 Issues

DNA Used to Predict Amputee’s Pain Levels

SAN FRANCISCO — Researchers now are able to predict which wounded servicemembers are likely to develop persistent, chronic pain after amputation based on variants in their individual DNA sequence. The report on the medical advancement,... View Article

2013 Issues

Legislators Call on VA to Stop Over-Prescription of Powerful Painkillers

By Sandra Basu WASHINGTON — In the wake of accusations that veterans are over-prescribed powerful painkillers, a House of Representatives subcommittee chairman called on VA to adopt more effective pain management protocols.  “The stakes are... View Article

2013 Issues

Sodium Channels Offer Path to Personalized Pain Management

By Annette M. Boyle Steven Waxman, MD NEW HAVEN, CT — Researchers at the West Haven VAMC and Yale University are moving closer to a new class of pain medications devoid of side effects and... View Article

2013 Issues

Careful Patient Management Essential for Mitigating Opioid Side Effects

By Annette M. Boyle Rollin M. “Mac” Gallagher, MD, MPH PHILADELPHIA – More than 50% of all VHA patients and more than 90% of those with polytrauma report experiencing chronic pain and, for many, only... View Article

June 2013

Study Finds Pain-Related Brain Anomalies in ‘Gulf War Illness’

WASHINGTON — Veterans suffering from “Gulf War Illness” appear to have anomalies in the bundles of nerve fibers that connect brain areas involved in the processing and perception of pain and fatigue — changes not... View Article

April 2013

Ofirmev Injection Available on VA Formulary For Relief of Mild/Moderate Pain

SAN DIEGO – Cadence Pharmaceuticals, Inc. announced that Ofirmev (acetaminophen) injection has been made available on the VA National Formulary (VANF) and must be available for prescription at all VA facilities. .Ofirmev is the first... View Article

Endocrinology

Military Pain Management’s Future: Less Invasive, More Data-Driven Techniques

By Col. Chester “Trip” Buckenmaier III, MD, program director, Defense and Veterans Center for Integrative Pain Management Col. Chester “Trip” Buckenmaier III, MD In August 2009, the Pain Management Task Force (PMTF) was chartered by... View Article

Addiction

No Longer Just a Horse Drug, Ketamine Increasingly Used for Military Pain Management

Annette M. Boyle ROCKVILLE, MD — Morphine has met its match — and then some. After 200 years as the gold standard in battlefield analgesia, morphine is increasingly giving way to ketamine, a phencyclidine (PCP)... View Article

Department of Defense (DoD)

Ketamine Resets System for Normal Pain Processing in Complex Syndrome Patients

By Annette M. Boyle BETHESDA, MD — For patients with intractable complex regional pain syndrome (CRPS), treatment with high doses of ketamine may offer a cure or dramatically reduce pain and improve functioning. Better still,... View Article

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