Pain Management

A placebo can work even when you know it’s a placebo

Mallika Marshall, MD
Mallika Marshall, MD, Contributing Editor

You may have heard of the “placebo effect,” in which people taking an inactive drug as part of a study actually experience an improvement in their symptoms. As it turns out, the placebo effect still exists if you tell people they’re taking a placebo. This “open-label placebo” strategy doesn’t work for every condition, of course, but it’s a promising way to relieve many common symptoms without medication.

Opiates no solution to back pain

Steven J. Atlas, MD, MPH

As the treatment for chronic pain morphs into more opiate prescriptions, the rate of addiction and its consequences continues to climb. This doesn’t mean we should stop treating pain or that everyone prescribed opiates will become addicted. But it should give us pause and make us realize that just taking a pill doesn’t fix chronic pain – and doing so cause harm us in the long run.

Tai chi may be as good as physical therapy for arthritis-related knee pain

Robert H. Shmerling, MD
Robert H. Shmerling, MD, Faculty Editor, Harvard Health Publications

Treatment options for osteoarthritis of the knee are limited, and many people turn to surgery as a last resort — so there’s a lot of interest in non-invasive treatments for this common condition. Researchers have just completed a head-to-head trial of standard physical therapy versus the traditional Chinese practice of tai chi, and they’ve found the latter is just as good as the former. If it’s something you’d like to try, go for it!

The opioid crisis and physician burnout: A tale of two epidemics

Steven A. Adelman, MD
Steven A. Adelman, MD, Contributor

Like many of us these days, doctors are feeling the pressure of being asked to do more work in less time. This burnout is a big problem for both doctors and their patients, and it has big consequences — some obvious, some less so. In this post, Dr. Adelman explores the relationship between physician burnout and another big problem facing the country — the opioid epidemic.

Opioid crisis: The difference between sympathy and empathy

Monique Tello, MD, MPH
Monique Tello, MD, MPH, Contributor

When a patient calls a new doctor begging for a refill on their pain medication, what should the doctor do? Denying medication to someone in significant pain seems unethical — but denying it to someone who’s suspected to be reselling it is a whole different story. Doctors now have systems in place to help them make the right call. But even these systems can’t replace the most critical piece of the puzzle — empathy.

The psychology of low back pain

Srini Pillay, MD
Srini Pillay, MD, Contributor

Some aspects of chronic back pain really are “in your head” — but that doesn’t mean you’re making it up. Rather, research has shown that when pain is chronic, the brain processes it not via the usual “pain” circuits, but via the “emotion” circuits. This means that you can actually reduce chronic pain by changing your psychological and emotional response to it. We’ve listed several techniques that have been proven to reduce chronic back pain.

Is there a “best” pain reliever for osteoarthritis?

Robert R. Edwards, Ph.D.
Robert R. Edwards, Ph.D., Contributing Editor

Osteoarthritis can contribute significantly to a reduced quality of life, and many arthritis sufferers have come to rely on pain medication for symptom control. A recent study compared NSAIDs against opioids for pain relief and found no significant difference between them. But as always, the right treatment choice for any individual person depends on their unique medical situation and what works best for them.

Why are doctors writing opioid prescriptions — even after an overdose?

Joji Suzuki, MD

A recent study of nearly 3,000 patients who had an overdose during long-term opioid treatment found that more than 90% of these patients continued to receive opioids — even after their overdose. Poor communication between emergency rooms and prescribing doctors is likely the culprit. What’s more, doctors receive little training in recognizing patients at high risk for overdose, or in treating addiction when they do spot it. An important strategy to address the current opioid crisis is to improve how doctors are educated about opioids.

Cold and flu warning: The dangers of too much acetaminophen

Susan Farrell, MD
Susan Farrell, MD, Contributing Editor

Many common cold and flu medications and prescription-strength pain relievers contain acetaminophen (Tylenol) as one of their active ingredients. If you take several of these drugs at once during a bout of cold or flu, you might accidentally take more than the safe dose of acetaminophen, potentially causing liver damage. It’s always best to read the labels — and to keep in mind that most winter viruses get better on their own with rest, fluids, and time.

The “right” goal when managing pain

Robert R. Edwards, Ph.D.
Robert R. Edwards, Ph.D., Contributing Editor

When it comes to pain management, focusing only on reducing the intensity of pain may lead to treatments that do as much harm as good. Ideally, pain-management plans should be tailored to each patient and include a range of therapies that not only reduce pain but also help improve pain-related quality-of-life problems.