Military Veterans are in Pain

November 9, 2019 Joe Brady

Pain is the most common medical condition requiring treatment for military personnel almost two-thirds of U.S. military veterans are in pain, and 9 percent are in severe pain.

Opioids are often prescribed for pain but, nearly 218,000 Americans died from overdoses related to prescription opioids between 1999 and 2017. Increasingly the military is looking for alternatives such as acupuncture meditation, yoga, Tai Chi, spinal manipulation, and other practices—to provide veterans with alternative strategies for pain management. 

In time for veterans day, the director for the National Center for Complementary and Integrative Health, Dr. Helene Langevin, M.D. has written a director’s message outlining the advances researchers are making in finding alternatives and the NIH-DoD-VA Pain Management Collaboratory an interagency partnership involving the U.S. Department of Health and Human Services (HHS), the U.S. Department of Defense (DoD), and the U.S. Department of Veterans Affairs (VA) to fund a multi-project research program focusing on nondrug approaches for pain management.

Read the directors message

https://nccih.nih.gov/about/offices/od/pain-us-military-and-veterans?nav=govd

Acupuncture vs intravenous morphine in the management of acute pain in the ED

Researchers conducted a randomized trial of acupuncture vs morphine to treat emergency room patients with acute onset moderate to severe pain. The study looked at 300 patients with acute pain: 150 in each group.

92% in the acupuncture group reported a pain score reduction ≥50% of its initial value. vs 78% in the morphine group P < .001. The acupuncture actually acted faster than morphine 16 ± 8 minutes in the acupuncture group vs 28 ± 14 minutes in the morphine group ( P < .005). In the morphine group 56.6% experienced adverse side effects and  only 2.6% in acupuncture group ( P < .001). In patients with acute pain presenting to the ED, acupuncture was associated with more effective and faster analgesia with better tolerance.

Read the study

https://www.ajemjournal.com/article/S0735-6757(16)30422-3/abstract

Mind-Body Therapies for Opioid-Treated Pain

A Systematic Review and Meta-analysis published in JAMA Intern Med. Looked at using mind-body therapies (ie, meditation, hypnosis, relaxation, guided imagery, therapeutic suggestion, and cognitive behavioral therapy) for pain reduction and reducing opioid use among adults using opioids for pain?

The study reviewed 60 randomized clinical trials with 6404 participants, mind-body therapies were associated with improved pain and reduced opioid dose.

The findings suggest that mind/body therapies are associated with improvements in pain and reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.

Read the Study 

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2753680