Psilocybin Is Going Mainstream, but Research and Regulation Lag

(Editor’s Note: President Trump has signed an executive order directing his administration to speed up the review of psychedelic drugs. Although the order focuses on treating mental health conditions, psychedelics such as psilocybin mushrooms have shown promise as treatments for chronic pain.)

By Hollis Karoly and Kent Hutchison

Amid a renaissance in the science of psychedelics, public interest in psilocybin – or magic mushrooms, as they’ve long been known – is surging.

One study found that rates of psilocybin use increased 44% among adults ages 18-29 from 2019 to 2023, and 188% among those over age 30. This amounts to more than 5 million adults using psilocybin in 2023 alone. And those numbers are rising: A study published in early 2026 found that about 11 million adults in the United States used psilocybin in the previous year.

In many ways, the growing scientific and public interest in psilocybin mirrors the early days of recreational cannabis legalization in the U.S. Much like how cannabis commercialization quickly outpaced the development of regulations necessary to protect public health, the expanding psilocybin market and surging public interest are moving faster than the science and regulations needed to ensure it is used safely.

We are substance use researchers who have spent more than a decade studying the many new, high-THC cannabis products that have flooded the legal-market.

Now, we similarly aim to bridge the gap between public enthusiasm for psilocybin and the limited scientific evidence available about its potential benefits and risks. Currently, this type of real-world data on the effects of psilocybin mushrooms is almost nonexistent.

How Do Psilocybin Mushrooms Work?

Psilocybin is a prodrug, which means that it has very low activity until the body converts it into psilocin. Psilocin is the compound primarily responsible for the psychoactive effects of psilocybin mushrooms.

Psilocin resembles the chemical messenger serotonin, which is involved in regulating a range of physiological and psychological functions, including mood, appetite, cognition and sensory perception. As a result, when psilocin binds to serotonin receptors, it alters how people think, feel and experience the world.

Importantly, research suggests that psilocin also alters the brain’s ability to strengthen or weaken neural connections, referred to as synaptic plasticity. This process likely underlies the profound and sometimes long-lasting effects psilocybin mushrooms can have on thoughts, emotions and perception.

Psilocybin mushrooms contain numerous other compounds, together known as tryptamines, such as baeocystin, norbaeocystin and aeruginascin. Research on rodents shows that mushrooms containing these compounds may elicit stronger and longer-lasting effects than psilocybin alone.

But very little is known about how these other tryptamines affect humans. This is because federal regulations require researchers to use an isolated, synthetic version of psilocybin in clinical studies rather than the entire mushroom.

Thus, the many ongoing clinical trials testing psilocybin as a treatment for various mental health conditions use synthetic psilocybin that does not contain these other tryptamines.

A Legal Gray Area

Psilocybin is more accessible than ever before.

In 2019, Denver, Colorado, became the first American city to decriminalize psilocybin mushrooms. This means that possession becomes the lowest law enforcement priority and criminal penalties are reduced or eliminated, but it does not fully legalize them.

Over the next two years, several other U.S. cities including Oakland and Santa Cruz, California; Seattle, Washington; and Detroit, Michigan, followed suit. In 2020, Oregon legalized psilocybin for supervised use in licensed settings, and Colorado did the same in 2022. These legal, supervised-use programs allow access to psilocybin mushrooms in regulated environments without a prescription.

Even for people living outside those states and cities, the barriers to accessing psilocybin mushrooms are low. With a quick Google search and around US$35, anyone can legally purchase kits containing the materials needed to grow psilocybin-containing mushrooms.

These kits are legal to buy and sell because they contain only mushroom spores, which are tiny reproductive cells from which mushrooms grow. Once these spores begin growing into mushrooms, they can produce psilocybin, making the mushrooms a federal Schedule 1 substance.

Because psilocybin mushrooms exist in this legal gray area and are governed by different rules across states, psilocybin mushrooms are essentially unregulated across most of the U.S.

As a result, consumers lack reliable information about what their mushrooms contain, how much they should take and how to use them safely.

Psilocybin Potency Is Increasing

Much like the cannabis industry, which has seen a steady increase in product variety and product strength since legalization, the psilocybin mushroom market is experiencing rapid growth.

For instance, psilocybin edibles are now available and increasingly popular.

In addition, selective cultivation practices are being used by individual and commercial growers to systematically increase the amount of psilocybin contained in their mushroom strains. For example, the Oakland Hyphae Cup, a community contest intended to identify the best mushroom strains, has shown wide variability in psilocybin content across samples.

Researchers are identifying a similar pattern of widely variable psilocybin content in scientific studies of psychedelic mushrooms from around the world.

Potential Harms of Psilocybin

Despite psilocybin’s therapeutic promise, it also carries risks. Psilocybin can cause headaches, nausea, dizziness and changes in blood pressure.

Less commonly, some people experience psychotic symptoms, suicidal thoughts, anxiety, paranoia, confusion or emotional distress.

Another serious potential side effect of psychedelic drugs is what’s known as hallucinogen persisting perception disorder. It involves ongoing perceptual distortions similar to those experienced while directly under the influence of psilocybin, which can persist for weeks, months or years, even once the psilocybin has left the body.

Harms are more likely when people take high doses.

As mushroom potency increases without market regulation, consumers may inadvertently ingest more psilocybin than intended, increasing the risk of harm. Without sufficient research on modern psilocybin products, consumers have little guidance on how to reduce potential harms.

Next Steps in Research and Regulation

Studying psilocybin in the real world requires creative research approaches.

Our team hopes to work within federal restrictions to study people using their own psilocybin mushroom products at home, while providing real-time data to our research team using app-based surveys.

Independent laboratories using state-of-the-art measurement techniques can aid researchers like us by providing information about the potency of the mushroom products that people are using.

While ongoing clinical trials provide important data about the effects of psilocybin under tightly controlled conditions, real-world data is needed to understand how modern psilocybin mushrooms are used and experienced by consumers.

These insights matter not only for scientists and policymakers but for the growing number of people trying psilocybin mushrooms for relief, self-improvement or out of curiosity. In a largely unregulated market, and with few clear guidelines on safe use, consumers are left to simply figure it out on their own.

Hollis Karoly, PhD, is a clinical psychologist, neuroscientist and Associate Professor of Psychiatry at the University of Colorado Anschutz Medical Campus. Her research is funded by the National Institutes of Health.

Kent Hutchison, PhD, is a Professor of Psychology and Neuroscience at the University of Colorado in Boulder and the Founder of the Center for Research and Education Addressing Cannabis and Health. His research is also funded by the National Institutes of Health.

This article originally appeared in The Conversation and is republished with permission.

Patients Are Becoming Less Open to AI in Healthcare

By Crystal Lindell

Many of us are using artificial intelligence (AI) in our everyday lives, such as learning more about our medical conditions and symptoms. But when it comes to actually using AI in their own healthcare, patients are less open to it.

That’s according to a new poll by The Ohio State University Wexner Medical Center, which surveyed 1,007 adults across the country about their opinions about AI in healthcare.

They found that just 42% of adults are open to AI being used as part of their healthcare in 2026. That’s down from the 52% who supported it in 2024. The belief that AI can make healthcare more efficient also fell, from 64% to 55%.

However, the survey found that over half of the adults (51%) still used AI to help them make important health decisions, without consulting with a medical professional.

Participants said they use AI for a variety reasons:

• 62% use AI to help understand symptoms

• 44% use AI to help explain test results or a medical diagnosis

• 25% use AI to compare treatments and help make a treatment decision

• 20% use AI to prepare for an upcoming medical appointment

The drop in patient trust with AI is on par with the natural “hype cycle” of any new technology, according to Ravi Tripathi, MD, chief health informatics officer at Ohio State Wexner Medical Center.

“When we first see something new and shiny, we think it's going to fix the world and replace health care and solve all of our medical problems,” Tripathi said. “People are learning that there are pros and cons of artificial intelligence, where it has actual use and where it really doesn't have a place.”

Tripathi predicts that over the next two to five years, trust in AI will increase, as people become more familiar with artificial intelligence and it becomes more common in healthcare technology.

But he warned patients against relying too heavily on AI for their own medical research.

“We know that 2% of the time AI is going to be inaccurate or it will potentially hallucinate,” Tripathi said. “Physicians are not using AI 100%. We're not trusting it 100%. I would be really concerned about a patient who is following AI. The artificial intelligence doesn't understand your story.” 

Tripathi suggests using AI in partnership with your doctor. AI can help patients compile their health data, explain test results and diagnoses, and help identify questions to ask providers.

“There's a strong value for using artificial intelligence as augmented intelligence,” Tripathi said. “Patients should have oversight of what the technology is doing but consult with their health care team for the final plan.”

While patients have mixed feelings about AI, doctors appear to be more open to it. 

According to a recent survey by the American Medical Association, 81% of physicians use AI to stay current on medical research and to help them with record keeping. That’s about double the rate in 2023, when the AMA first polled doctors on their AI use.

While 76% of physicians say AI technology can help with patient care, about 40% said they are both excited and worried about it – citing concerns about patient privacy and the integrity of the patient-physician relationship.

The global AI healthcare market is projected to reach $868 billion by 2030, with its influence on the overall healthcare market more than doubling from roughly 15% today to over 30% by 2030.

Can Hypnosis Therapy Treat Chronic Pain?

By Pat Anson

The same academic institution that helped launch a nationwide crackdown on opioid medication has a new suggestion on how to treat chronic pain: hypnosis.

Researchers at the University of Washington enrolled 127 people with moderate to severe pain from spinal cord injuries in a study to see if hypnotic cognitive therapy could reduce their pain levels. 

For one hour every week for six weeks, half the participants met with a psychologist over the telephone or online Zoom calls for instructions on how to practice self-hypnosis. The other half did not get hypnosis and served as a control group. 

Both groups continued to get “usual care” for their pain throughout the study. About 75% of them were taking opioids or another prescription pain medication. 

Patients who received hypnosis were not put into a trance, like you might see on TV or in comedy acts, but received a form of cognitive behavioral therapy. Through hypnotic suggestions, patients were told to relax, breathe deeply, and imagine themselves in a comfortable place without pain. Participants were given recordings of each therapy session, and told to listen to them daily and practice self-hypnosis three times a day.

After six weeks of hypnotic therapy, participants reported that their pain levels dropped by 19.3%. Self-reported pain continued to decrease after the sessions stopped, falling by 24.5% after 12 weeks. Nearly half (46%) said their pain improved meaningfully. There were also significant improvements in sleep and depression, compared to patients in the control group.

The study was completed four years ago, but the findings are only now being published in the journal Neurology. 

“Not only did the study show that this treatment is effective, but unlike most medications used for pain, it is a treatment with many positive side effects, like improved sleep and a greater sense of self-control,” senior author Mark Jensen, PhD, a Professor of Rehabilitation Psychology at UW, said in a press release.

 “I think that, based on the evidence, including the side-effect profile, this is the first treatment that people with chronic pain should be offered.” 

Although Jensen said hypnosis should be the “first treatment” for pain, the published study indicates otherwise. The research team called hypnosis an “adjunctive treatment” for pain – which means it should be used as a secondary treatment, alongside a primary treatment such as pain medication.

Like cognitive therapy, hypnosis helps patients stop thinking that their pain won’t go away and will only become worse.  

“Hypnosis helps patients be more open to ideas about changing their thinking and internalizing those ideas,” said first author Charles Bombardier, PhD, a psychologist and Professor of Rehabilitation Medicine at UW. 

Although there’s a certain amount of stigma about hypnosis, co-author Elena Mendoza, PhD, told The Seattle Times that hypnosis is an effective way to reduce pain and is less risky than opioids.

“Hypnosis is not about what you see on the movies. It is a clinical, therapeutic technique. We use it every day in a clinical context, and it’s working well,” said Mendoza, a Research Assistant Professor at UW who specializes in hypnosis and conducted the study’s therapy sessions. 

“We really want to give people ways to manage their pain that are nonopioids. We hope this research is a step toward that,” she said.

Professors at the University of Washington have a long history of campaigning against the use of opioids. In 2007, several helped develop Washington state’s medical guideline on the use of opioids, one of the first in the country to set dosage limits.   

Professors Jane Ballantyne, MD, Gary Franklin, MD, Mark Sullivan, MD, and David Tauben, MD, were among the original members of Physicians for Responsible Opioid Prescribing (PROP), an anti-opioid activist group.

Ballantyne, Franklin and Tauben also helped draft the CDC’s controversial 2016 opioid guideline. Opioid prescribing nationwide has fallen in half since the guideline’s release.

GLP-1 Drugs Offer Real Hope for People With Pain or Addiction

By Dr. Lynn Webster

In Greek mythology, the goddess Panacea carried a potion that could heal any disease. It’s a seductive image, and it’s how GLP-1 drugs can start to feel as reports pile up about their potential in treating conditions besides diabetes and obesity.

A recent Washington Post article alludes to Panacea before describing the emerging signs that people living with pain or addiction might benefit from GLP-1s.  

The promise is real. So are the risks. If GLP-1s are going to move from metabolic medicine into the worlds of pain and substance use disorders, we should talk about them the way we would talk about any powerful new class: with evidence, not mythology.

What We Know About GLP-1s and Pain

The most solid pain evidence so far involves knee osteoarthritis — a condition where weight, inflammation, and function are tightly linked. In a 68-week placebo-controlled trial, once-weekly semaglutide (Ozempic, Wegovy) injections in people with obesity and moderate knee osteoarthritis produced significantly greater reductions in body weight — along with significant improvements in pain scores and better physical function.  

That is meaningful. But it doesn’t automatically make semaglutide a “pain drug.” Weight reduction can relieve joint pain, and metabolic improvements may dampen inflammation. Researchers are still sorting out what portion of the pain relief is caused by weight loss alone.  

Outside osteoarthritis, the evidence is thinner. Preclinical studies suggest GLP-1 receptor agonists may reduce neuropathic pain through anti-inflammatory and neuroprotective effects.  

One promising real-world signal comes from fibromyalgia. A large analysis of over 96,000 patients found GLP-1 use associated with significantly lower odds of needing an opioid prescription or of being diagnosed with chronic pain and/or fatigue.   

These observational data are hypothesis-generating, but require confirmation in future studies. More rigorous randomized trials for fibromyalgia, diabetic neuropathy, and other chronic pain syndromes are needed.

What We Know About GLP-1s and Addiction

Here the signal is surprisingly strong — but still preliminary. The evidence so far suggests that GLP-1s appear to modulate reward pathways in the brain that shape craving and compulsive drug use.

A large 2026 observational study of over 600,000 U.S. veterans with type 2 diabetes found that GLP-1s were associated with lower risk of developing substance use disorders (SUDs) involving alcohol, cannabis, cocaine, nicotine or opioids. Among those with preexisting SUDs, GLP-1s were linked to lower risks of emergency room visits, hospitalizations, mortality, overdose, and suicidal thoughts or attempts.

Observational data can’t prove causation, but the consistency across substances and outcomes provides a strong rationale for clinical trials.

We also have randomized evidence in alcohol use disorder. A small Phase 2 trial of 48 adults with alcohol use disorder found that once-weekly semaglutides reduced drinking and cravings over nine weeks compared with placebo.

More research is underway. A recent systematic review identified 33 registered trials looking at GLP-1s for SUDs, predominantly for alcohol and nicotine, but with growing interest in opioid and stimulant SUDs.  

The Risks We Can’t Minimize

The common side effects of GLP-1s — nausea, vomiting, diarrhea, constipation and appetite suppression — are often manageable, but they can be therapy-ending. That matters, because many GLP-1 benefits appear to fade when treatment stops.

In pain and addiction care, “stop-start” patterns are common when insurance coverage shifts or supply is disrupted. Those interruptions are often risky.

A 2026 Washington University School of Medicine analysis of veterans with type 2 diabetes found that even brief interruptions of GLP-1 treatment -- as little as six months -- were associated with higher risk of heart attack, stroke, and death compared with continuous use. The risks rise even further the longer the gap, with up to 22% higher risk of a major cardiovascular event after two years off therapy.  

More concerning are rare but serious complications. Reports of severe delayed gastric emptying (stomach paralysis) remain a clinical concern. Cohort studies have also reported an association between semaglutides and neuropathy in patients with diabetes, although causality remains debated and the absolute risks are low.  

Emerging observational data have raised questions about musculoskeletal safety, with special relevance for people already limited by pain. Some analyses link GLP-1 use to modest reductions in bone mineral density and possible increases in osteoporosis or fracture risk in older adults. Tendon injuries have also appeared in some patients with obesity.  

These findings need replication. Because GLP-1s can slow stomach emptying, clinicians must plan around procedures. The American Society of Anesthesiologists recommends individualized perioperative strategies, including temporary liquid diets for some higher-risk patients.

A Measured Path Forward

GLP-1s may end up helping people with pain and addiction — and if they do, that would be a genuine advance. But we should not rush from “promising” to “proven,” or expand GLP-1 use without a clear plan for monitoring and safety.

Panacea was a Greek myth about curing everything. The modern task — identifying who benefits, who is harmed, and how to use powerful medicines in ways that reduce suffering without creating new forms of it — is harder.

That will require larger, dedicated randomized trials in addiction, targeted studies in pain syndromes beyond knee osteoarthritis, longer-term musculoskeletal safety data, and honest communication about both the promise and the risks of GLP-1s.

Lynn R. Webster, MD, is Senior Fellow at the Center for U.S. Policy and is co-author of the forthcoming book, “Deconstructing Toxic Narratives: Data, Disparities, and a New Path Forward in the Opioid Crisis,” to be published by Springer Nature.

Collagen Supplements Help Reduce Joint Pain

By Heba Ghazal

Collagen supplements have become one of the bestselling products in the wellness industry, promising everything from smoother skin to stronger joints. But do they actually work?

A major new review of the evidence – pulling together data from 113 clinical trials – suggests that, for some health outcomes, the answer is probably yes. But as ever with nutrition science, the full picture is more complicated.

Collagen is a protein the body makes naturally. It gives skin its structure and elasticity, supports bones and muscles, helps wounds heal and plays a role in protecting organs. The problem is that production slows as we age, which is why so many people turn to supplements to top it up.

Not all collagen is the same, though. The collagen found naturally in food may be less well absorbed than the smaller forms used in most supplements. These hydrolysed forms – where the protein has been broken down into shorter chains called peptides – are thought to pass more readily into the bloodstream and making it easier for the body to transport these fragments to tissues where they may have biological effects, potentially supporting skin, joint and muscle health.

The new review examined research published up to March 2025, drawing on 16 systematic reviews that between them included nearly 8,000 participants. The overall picture was cautiously positive.

Collagen supplementation was linked to moderate improvements in muscle health and reduced pain in people with osteoarthritis. There were also improvements in skin elasticity and hydration – though these benefits built up gradually, suggesting that taking collagen consistently over a longer period matters more than a short-term burst.

Some of the findings were less clearcut. Results for skin elasticity and hydration shifted depending on when the studies were conducted, with newer research showing lower improvements in elasticity but greater improvements in hydration. That inconsistency is worth noting – it suggests the science is still settling.

The quality of the research itself is also worth scrutinising. The studies used a wide variety of methods, doses and ways of measuring outcomes, which makes direct comparisons difficult.

Fifteen out of the 16 reviews included were rated as low or critically low quality – not necessarily because the supplements don’t work, but because of methodological problems such as studies not being registered in advance and poor reporting on potential biases. Many trials were also short and included few participants, which limits what we can reliably conclude about long-term effects.

Not All Collagen Is Equal

Part of the problem is that collagen supplements vary enormously. Some are derived from animals, such as cows, pigs and chickens, and others come from marine sources, including fish, jellyfish and shellfish. There are even so-called “vegan” collagen alternatives. Some studies used oral supplements, while others tested collagen dressings applied to the skin.

The way collagen is processed also affects the size and composition of the peptides in the final product, which in turn influences how it behaves and is absorbed in the body. Lumping all these different products together in a single analysis risks obscuring as much as it reveals.

Individual differences matter too. Factors such as sun exposure, smoking, sleep quality, environment and hormone levels all affect how skin ages and how it might respond to supplementation. If studies fail to account for these variables, it becomes very difficult to know whether any observed changes are genuinely due to the collagen or simply reflect differences in participants’ lifestyles.

This review adds to a growing body of evidence suggesting collagen supplements are not simply expensive placebos. There appear to be real, if modest, benefits – particularly for skin hydration, joint pain and muscle health.

The research base still has significant gaps. Without more rigorous, standardised studies, it remains genuinely difficult to say what is driving those benefits, or who is most likely to see them. Studies need to clearly specify the type of collagen used, the dose, how it was delivered and the characteristics of the people taking it.

Heba Ghazal, PhD, is a Senior Lecturer in Pharmacy at Kingston University in London.

This article originally appeared in The Conversation and is republished with permission.

TENS Helps Reduce Symptoms of Fibromyalgia

By Pat Anson

In the first clinical study of its kind, researchers at the University of Iowa found that transcutaneous electrical nerve stimulation (TENS) significantly reduces pain and fatigue in patients with fibromyalgia, when combined with physical therapy.

Fibromyalgia is a poorly understood and difficult-to-treat disorder that causes widespread body pain, fatigue, insomnia, and brain fog. 

The study involved 384 people with fibromyalgia, and was conducted at 28 outpatient physical therapy clinics in the Midwest. Participants were broken into two groups, with half receiving physical therapy (PT) with TENS or physical therapy alone. TENS units send mild electric currents into sore muscles and tissues to temporarily relieve pain. 

TENS electrodes were placed on the upper and lower backs of patients, and delivered a mixed frequency signal at an intensity as strong as the participant could tolerate. Patients were asked to use TENS for two hours a day for six months. The treatments could be split into short periods or done all at once. 

The study findings, published in JAMA Network Open, show patients in the TENS/PT group had significant improvement in their movement-based pain and fatigue after 60 days, while those who only received physical therapy had no change in their pain. The improvements in the TENS/PT group were dose-dependent, with people using TENS daily having the best outcomes. 

After 60 days, patients in the physical therapy group were also given TENS units, and all the participants continued in the study for another four months.  

“When we gave the PT-only patients the TENS unit and they started using it, we also saw the same improvements as the PT with TENS patients,” said lead author Kathleen Sluka, PhD, a Professor of Physical Therapy and Rehabilitation Science at University of Iowa.

The improvements in fatigue were notable, because reduced fatigue makes people more willing and able to have physical therapy.

“We were excited to see that patients also had less fatigue,” Sluka added. “Right now, there are no good treatments for fatigue. So, the fact that we had anything that touched the fatigue was pretty powerful.” 

After six months, 81% of participants found TENS helpful and over half (55%) were still using TENS daily.

Researchers say it’s important for people to realize that the benefit of TENS comes from using it as a part of a total treatment plan.  

“Using TENS on its own will not give the same benefits,” said first author Dana Dailey, PhD, an Assistant Research Scientist at the University of Iowa.  “All the study participants were also using pain medications and receiving physical therapy, yet TENS still provided additional relief.” 

Until recently, the only three medications were FDA-approved for fibromyalgia: duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella). Many patients consider the drugs ineffective or have too many side effects.

Last year, the FDA approved Tonmya, a fourth drug for the treatment of fibromyalgia in adults. Tonmya is a new formulation of an old drug: cyclobenzaprine hydrochloride (Flexeril), a muscle relaxant that was originally developed as an antidepressant. 

Low Vitamin D Levels Linked to Chronic Low Back Pain

By Pat Anson

Low levels of Vitamin D are a leading cause of disability worldwide and have been associated with fibromyalgia, rheumatoid arthritis, migraines, and musculoskeletal problems. 

A new study in India suggests the “sunshine vitamin” may also play a role in the development of chronic low back pain.

Researchers at a teaching hospital in eastern India took blood samples from 75 adult patients with chronic low back pain and found a remarkably high rate of low vitamin D serum levels – a condition known as hypovitaminosis D.

Over two-thirds of the patients (69.3%) had “deficient” levels of Vitamin D, while the remaining ones had serum levels that were below normal and considered “insufficient.” 

“Notably, none of the participants had sufficient serum vitamin D levels. These findings are in agreement with existing literature reporting a high prevalence of hypovitaminosis D in the Indian population, even in regions with adequate sunlight exposure,” wrote lead author SK Imran Ali, MD, an orthopaedic surgeon at Dr. Bidhan Chandra Roy Hospital in Haldia. 

Ultraviolet rays in sunlight are the principal source of Vitamin D for most people. India usually gets a significant amount of sunshine, especially from October to May, so why would Vitamin D levels be so low?

Vitamin D deficiency rates on the Indian subcontinent range from 50% to as high as 95%, a phenomenon attributed to darker skin pigmentation, poor diets, and increasingly sedentary (indoor) lifestyles with little sun exposure.

While researchers found an association between chronic low back pain and hypovitaminosis D, they did not establish a causal link. Pain severity and disability levels were about equal between the “deficient” and “insufficient” groups, and between men and women.

Researchers did find that patients from lower socioeconomic classes were statistically more likely to have inadequate Vitamin D levels compared to those in the upper class.

“This observation aligns with existing evidence indicating that socioeconomic factors influence nutritional status, sun exposure, dietary quality, and access to healthcare services, all of which may affect vitamin D levels,” researchers found. “Individuals from lower socioeconomic backgrounds may have limited access to vitamin D-rich foods, reduced opportunities for outdoor activity, and decreased healthcare access, thereby increasing the risk of hypovitaminosis D.”  

In addition to sunshine, you can increase your Vitamin D levels by eating oily fish and eggs. Vitamin D has a wide range of positive health effects, such as strengthening bones and teeth, and inhibiting the growth of some cancers. Vitamin D also improves immune function and reduces inflammation.

Every Chronic Pain Patient Should Have Their Hormone Levels Tested

By Dr. Forest Tennant

Periodic hormone panel testing should be a standard procedure in chronic pain care. Why? Some specific hormones are essential for pain control and others for healing and restoration of damaged tissues. 

Unfortunately, both chronic pain and opioid medications can suppress hormones, which the body needs for pain control and tissue healing. Nerve receptors in the brain that control pain, such as the opioid/endorphin, dopamine, GABA, and serotonin receptors, use hormones as energizers – the same way gas is needed to fuel your car. 

One of the first signs that your hormone levels are deficient — and that you’re running out of gas —- is when your pain relief medication seems to be losing its effectiveness. If that is the case, hormone panel testing should be performed and hormone replacement may be necessary. 

Six hormones that you should test for:

• Pregnenolone

• Progesterone

• Dehydroepiandrosterone (DHEA)

• Estradiol

• Testosterone

• Cortisol

Opioids can suppress all of these hormones. Long-acting opioids like oxycodone, morphine, methadone, fentanyl patches, and intrathecal opioids are the worst.

Short-acting opioids like hydrocodone and hydromorphone are less disruptive, because they do not constantly remain in the blood, so they give the pituitary and other hormone-producing glands time to recover. 

Long-acting opioids constantly suppress the pituitary and other glands. Consequently, any person who takes a long-acting opioid needs hormone panel testing at least every 6 months. All deficiencies must be replenished.

Hormone Therapies

Given the importance of hormone testing and hormone replacement therapy, I recently published a new book, “Hormone Therapies in Chronic Pain Care.”

I wrote the book because I strongly believe it is time to incorporate hormonal therapies into the care of essentially every chronic pain patient.  

Despite an imperfect pain care system that admittedly has some supply, regulation, and financial issues, modern pain management has achieved great success.  

Recently developed medications, physical therapies, and surgical procedures have brought pain relief and recovery to millions around the world.  Hormones can and will build on this foundation. 

The book is designed to help both medical practitioners and patients identify hormone therapies that can improve their current treatment. You can’t control pain or acquire healing and restoration with deficient hormone levels.

Forest Tennant, MD, DrPH, is retired from clinical practice but continues his research on the treatment of intractable pain and arachnoiditis. Readers interested in learning more about his research should visit the Tennant Foundation’s website, Arachnoiditis Hope. You can subscribe to its research bulletins here.   

The Tennant Foundation gives financial support to Pain News Network and sponsors PNN’s Patient Resources section. 

PEA: A Supplement That Helps Reduce Pain and Inflammation

By Julie Titone

It is a question I’ve long had but never bothered to look up: How do drugs get their names? Then I heard about palmitoylethanolamide and, given it has the longest name of anything I ever considered consuming, I had a solid reason to pursue the question.

PEA, as the tongue-twister is unsurprisingly known, isn’t a prescription drug. It’s a fatty acid found naturally in our bodies and in some foods. PEA can also be manufactured and is sold in over-the-counter supplements. It binds to cells in the body and reduces inflammation and pain.

When a fellow arachnoiditis sufferer called it to my attention, I read up on it.

PEA was first identified in the 1950s, after doctors observed that children who ate eggs were less likely to get rheumatic fever. Early studies found PEA not only in the fatty solids of egg yolks, but also in components of peanuts and soybean lecithin.

Researchers found that the compound had anti-inflammatory effects in animal models, and noticed it could also reduce allergic reactions. That lead to early clinical trials for conditions like influenza and the common cold.

Interest in PEA then dropped off for two decades. It was revived again thanks in large part to Nobel Prize-winning neurobiologist Rita Levi-Montalcini. Her work in the 1990s and 2000s helped establish PEA's role in modulating mast cells, which are key players in inflammation and allergic responses. She was a huge fan of PEA, reportedly taking it herself. She lived to be 103.

Interest in PEA is strong and getting stronger. For two recent reports, researchers analyzed scores of studies, tabulated the results of the rigorous ones, and reached upbeat conclusions.

The 2023 meta-analysis in the Swiss journal Nutrients looked at PEA’s effect on chronic pain, and found “PEA was associated with improved functional status and quality of life in many studies, while reported side effects were essentially negligible.”

A 2025 meta-analysis published by the journal Nutrition Reviews confirmed that “PEA effectively reduces pain and enhances quality of life, with significant benefits observed within 4-6 weeks of treatment. Palmitoylethanolamide is a promising alternative to chronic opioid analgesics, potentially reducing the risk of opioid abuse and dependency.”

That last point — that PEA could provide a safe alternative to opioids — is a big driver of interest in the nine-syllable compound. Researchers are also looking at its promise in treating long Covid, glaucoma, Alzheimer’s, Parkinson’s, ALS and more. So far, it’s shown to be most effective in the treatment of neuropathic pain.

To make PEA more effective, researchers have figured out how to make it more available in the body. Thus “micronized,” PEA is now available in some countries as a prescription drug. Why didn’t that happen earlier? For one thing, drug manufacturers apparently didn’t see great promise or profit in it.

Chemists also discovered PEA before the United States and WHO came up with national and international naming councils, which give drugs generic names such as ibuprofen.

Manufacturing marketing teams are the ones who come up with brand names. Though I find it hard to picture a room full of those folks looking at PowerPoint slides, rubbing their chins thoughtfully until someone exclaims “Yes! Let’s call it Advil! That certainly says ‘Be gone, demon headache’ to me!”

Am I taking PEA? Yes, dear reader, I am. For the past three weeks. Because the research says it takes four to six weeks to see results, I have nothing to report. Perhaps PEA won’t show definitive improvement, but works in the background to keep my inflammatory spinal disease from getting worse.

I would certainly take that outcome from a supplement that is readily available, doesn’t break the bank, and has no side effects.

Following a career in journalism and academic communications, Julie Titone writes about health, environment and other issues at julietitone.substack.com.

As Anxiety Grows, More Americans Turn to Antidepressants

By Phillip Reese, KFF Health News

After a grueling year of chemotherapy, surgery, and radiation to treat breast cancer, Sadia Zapp was anxious — not the manageable hum that had long been part of her life, but something deeper, more distracting.

“Every little ache, like my knee hurts,” she said, made her worry that “this is the end of the road for me.”

So Zapp, a 40-year-old communications director in New York, became one of millions of Americans to start taking an anxiety medication in recent years. For her, it was the serotonin-boosting drug Lexapro.

“I love it. It’s been great,” she said. “It’s really helped me manage.”

The proportion of American adults who took anxiety medications jumped from 11.7% in 2019 to 14.3% in 2024, with most of the increase occurring during the covid pandemic, according to survey data from the Centers for Disease Control and Prevention. 

That’s 8 million more people, bringing the total to roughly 38 million, with sharp increases among young adults, people with a college degree, and adults who identify as LGBTQ+.

Even as psychiatric medications gain public acceptance and become easier to access through telehealth appointments, the rise of a class of antidepressants called selective serotonin reuptake inhibitors, known as SSRIs, has triggered a backlash from supporters of the “Make America Healthy Again” movement who argue they are harmful. 

Doctors and researchers say medications such as Prozac, Zoloft, and Lexapro are front-line treatments for many anxiety disorders, including generalized anxiety disorder and panic disorder, and are being misrepresented as addictive and broadly harmful even though they’ve been proved safe for extended use.

Health and Human Services Secretary Robert F. Kennedy Jr. has decried broadening SSRI use. During his 2025 confirmation hearing, he said he knows people, including family members, who had a tougher time quitting SSRIs than people have quitting heroin. More recently, he said his agency is studying a possible link between the use of SSRIs and other psychiatric medications and violent behavior like school shootings.

Food and Drug Administration Commissioner Marty Makary has also suggested that SSRI use among pregnant women could lead to poor birth outcomes.

SSRIs’ common side effects include upset stomach, brain fog, and fatigue. Some SSRIs also can reduce libido and cause other sexual side effects.

For many people, however, the side effects are mild and tolerable and the benefits of treating chronic anxiety are worth it, said Patrick Kelly, president of the Southern California Psychiatric Society. “The statements about SSRIs were just not grounded in any sort of evidence or fact,” Kelly said of Kennedy’s comments.

A recent comprehensive study showed that over half of people with generalized anxiety disorder taking an SSRI saw their anxiety symptoms reduced by at least 50%. Side effects prompted about 1 in 12 to stop taking an SSRI.

“When it’s being done right and when you’re also using appropriate therapy techniques, SSRIs can be really, really helpful,” said Emily Wood, a psychiatrist who practices in Los Angeles.

MAHA Blames Anxiety on Poor Diet, Lack of Exercise

Supporters of MAHA have partly blamed poor dietary choices and the increase of a sedentary lifestyle for the rise of a number of health problems, including anxiety, depression, and other mental health disorders. 

As a remedy, they have called for measures such as reducing consumption of ultraprocessed foods, which studies in recent years have connected to depression and anxiety, and cutting back on screen time in favor of exercise.

Psychiatrists often encourage a healthy diet and exercise as an adjunctive therapy for anxiety and depression. Wood said those who can manage anxiety without medication should also consider talk therapy. 

The proportion of American adults using mental health counseling boomed from 2019 to 2024 as teletherapy grew in popularity, federal data shows. “Anxiety disorders are amongst our psychiatric disorders that really respond well to cognitive behavioral therapy,” she said.

But medication can help.

Studies show the risks of taking SSRIs during pregnancy are low for mother and child. By contrast, “depression increases your risk for every complication for a mother and a baby,” Wood said, adding that recent statements by government officials about SSRI use during pregnancy are “potentially leading to real harm for these women.”

Some people who stop taking antidepressant medication will experience nausea, insomnia, or other symptoms, especially if they quit suddenly. But “the concept of addiction simply does not apply to these chemicals,” Kelly said, a statement backed up by studies.

Addiction, though, is a possibility with benzodiazepines such as Xanax that are often a second line of treatment for anxiety. These controlled substances can also increase the risk of opioid overdose in patients taking both types of drugs. During congressional hearings last year, Kennedy also decried benzodiazepine overuse as a problem.

While benzodiazepines are effective for short-term use, they require monitoring and care, Wood said.

“Those are really great meds for acute anxiety and not great as long-term anxiety medications, because they are habit-forming over time,” Wood said. “If you’re taking them on a daily basis, you’ll need more and more to get the same effect, and then you have to come down from them in a tapered way.”

And an increasing number of people are also occasionally taking beta-blockers such as propranolol for anxiety. Some people use beta-blockers to prevent a racing heart before a public speech or other big moments, even though they are not FDA-approved for treating anxiety and are prescribed “off-label.”

Beta-blockers can cause dizziness and fatigue, but they are “nonaddictive, really helpful for bringing down the autonomic nervous system, going from fight or flight to something more neutral, and really safe,” Wood said.

Social Changes Drive Increased Use of Anxiety Meds

A number of leading theories could explain why so many more people are taking anxiety medication, including increased social media use, more isolation, and heightened economic uncertainty, physicians and researchers say.

Plus, the medicines are relatively easy to get. Many people obtain SSRI and benzodiazepine prescriptions from their primary care physician. Others obtain the medications after a brief teletherapy appointment.

Many social media influencers talk about their mental health struggles, easing some stigma among young people and encouraging them to get help. About a third of teens in a recent study said they get mental health information via social media.

Still, increased access to anxiety medication can be a problem when combined with a trend of self-diagnosis based on social media trends. A Google search for “buy Xanax online” leads to sponsored promises of same-day treatment, though fine-print disclaimers clarify that a prescription is not guaranteed.

“I think increased access is good, but that’s not the same thing as, you know, ordering Xanax online,” Kelly said.

Young adults are largely driving an increase in anxiety medication use. The proportion of Americans ages 18 to 34 taking anxiety medication rose from 8.8% in 2019 — the first year such survey data became available — to 14.6% in 2024. By contrast, the rate didn’t change much among adults 65 and older, CDC data shows.

The pandemic and covid lockdowns greatly increased stress among many American adults, particularly young adults.

And data shows more women than men take anxiety medication. Jason Schnittker, a department chair and professor of sociology at the University of Pennsylvania, said that’s because they’re more likely to need them. They are also likelier than men to report when they feel anxious, and doctors are “inclined or see anxiety more readily in their female patients than their male patients,” Schnittker added.

Broader trends could also be at work. Schnittker said studies have shown anxiety growing more prevalent among ensuing generations for much of the 20th and 21st centuries. 

Schnittker, author of Unnerved: Anxiety, Social Change, and the Transformation of Modern Mental Health, said growing income inequality could be partly to blame, with people feeling stress over improving their economic status. Social and religious activities have been replaced by more isolation. And people have become more suspicious of others, creating a sense of unease around strangers.

For Zapp, the cancer survivor, it took a few months on Lexapro before she started seeing clear results. When she did, she said, it felt like her mind was less noisy, making it easier to focus. She also underwent talk therapy, but now her chronic anxiety is stabilized on medication alone.

“It definitely helped me get back to my day-to-day in a way that was productive and not just riddled with my anxieties throughout the day,” she said.

KFF Health News is a national newsroom that produces in-depth journalism about health issues.

Microcurrent Therapy: The Healing Electrical Stimulation You’ve Never Heard Of

By Madora Pennington

If you suffer from chronic muscle or soft tissue pain, a physical therapist or doctor may have recommended you get a TENS unit.

A traditional TENS (Transcutaneous Electrical Nerve Stimulation) device sends a low-voltage current through an injured area of the body, attempting to disrupt pain signals and stimulate endorphins, the body’s natural painkillers. The reviews of TENS are mixed. Some people experience relief from TENS, but many do not. 

There is another kind of TENS that few patients and providers know about called microcurrent therapy (MCT). These devices deliver an electric current so small, the user might not feel anything. That’s because the current approximates the body’s own energy flows. The goal of MCT therapy is not to block pain sensation, but to encourage actual healing.

The human body itself is a complex electrochemical machine. Your cells generate low levels of electricity through chemical reactions called “biocurrents” -- which power bodily functions, regulate nerve signaling, boost cellular growth and energy, reduce inflammation, and so on. When body tissue is damaged, it produces an altered current that doesn’t work as well. 

Stimulating the body with an external microcurrent accelerates tissue repair, wound healing, and muscle recovery. In short, it speeds healing by assisting with energy at the cellular level. The current from a traditional TENS, while low, is still much higher than the electrical currents the body runs on, so it does not improve the electrical functioning of cells. 

For me, I never felt much benefit from a traditional TENS. So when I read articles about microcurrent therapy, I wanted to try it. I asked my physical therapist, and she had never heard of anything but a traditional TENS current, even though she is a recent graduate of a doctoral program, and an excellent PT. 

I checked the various TENS units I already own, and none had the capacity to produce a microcurrent.

John Hubacher, President and CEO of Pantheon Research, a biomedical instrument manufacturing company, thinks microcurrent therapy may have gotten left behind because it was unclear why it worked so well. Without a clear mechanism for physiological action, it’s hard to get studies done. But now research is emerging that shows that MCT has the potential to change a cell's physiological processes.

Microcurrents have been shown to improve skin ulcers, varicose veins, and wound healing. It is also being used for cosmetic purposes as a “natural facelift” to tighten and tone skin, stimulate facial muscles, and boost collagen and elastin production. There are practically no side-effects, and it can be safely used in elderly populations.

Combining microcurrent therapy with exercise can be very helpful. Microcurrent used before and after a workout improves fat breakdown and reduces muscle soreness. Mice with atrophied muscles experienced muscle regrowth from the application of microcurrent therapy.

A 2025 paper remarked that this low-risk, powerfully therapeutic and inexpensive technology is grossly underutilized due to lack of awareness, even though studies support that it improves pain and function in many musculoskeletal conditions.

“Despite a growing body of evidence highlighting its therapeutic potential, MIC (MTC) therapy remains underutilized across many areas of medicine. Its subsensory, low-intensity electrical currents offers a non-invasive, pain-free alternative to traditional electrotherapies like TENS, without triggering muscle contraction or discomfort,” wrote lead author Sarahrose Jonik, MD, a Resident of Internal Medicine at Penn State College of Medicine.

“MIC therapy shows promise as an adjunctive modality capable of supporting tissue repair, reducing inflammation, and modulating pain, particularly in complex, chronic, or refractory conditions.” .

After an internet search, I bought the InTENSity 12 made by Compass Health. It looks and operates like a typical TENS and costs about the same, but produces a microcurrent. Like a TENS device, it has sticky pads that you attach to the skin near the area you want to work on. 

I first used the InTENSity 12 on an area around my hip that is constantly tight. There, my muscles overwork to compensate for an old knee injury. It is an area I always have to work on and have had much physical therapy for.

The microcurrent absolutely melted the tension like no stretching, heat, massage, or trigger point release ever came close to doing. I did some stretching afterwards. The area released even more deeply and completely. My formerly hyperactive muscles stayed soft and easy to stretch for days. 

Using the microcurrent TENS on other painful areas caused by other old injuries and a neuropathy flare, I felt relief that lasted for days. It left me wondering if this extra power, when delivered at the same level at which my cells operate, caused healing that my body was not doing on its own. 

Medicare Pilot Program Could Deny Coverage of Pain Treatments

By Grace Mackleby and Jeff Marr

Medicare has launched a six-year pilot program that could eventually transform access to health care for some of the millions of people across the U.S. who rely on it for their health insurance coverage.

Traditional Medicare is a government-administered insurance plan for people over 65 or with disabilities. About half of the 67 million Americans insured through Medicare have this coverage. The rest have Medicare Advantage plans administered by private companies.

The pilot program, dubbed the Wasteful and Inappropriate Service Reduction Model, is an experimental program that began to affect people enrolled in traditional Medicare from six states in January 2026.

During this pilot, medical providers must apply for permission, or prior authorization, before giving 14 kinds of health procedures and devices. The program uses artificial intelligence software to identify treatment requests it deems unnecessary or harmful and denies them. This is similar to the way many Medicare Advantage plans work.

As health economists who have studied Medicare and the use of AI in prior authorization, we believe this pilot could save Medicare money, but it should be closely monitored to ensure that it does not harm the health of patients enrolled in the traditional Medicare program.

Prior Authorization Required

The pilot marks a dramatic change.

Unlike other types of health insurance, including Medicare Advantage, traditional Medicare generally does not require health care providers to submit requests for Medicare to authorize the treatments they recommend to patients.

Requiring prior authorization for these procedures and devices could reduce wasteful spending and help patients by steering them away from unnecessary treatments. However, there is a risk that it could also delay or interfere with some necessary care and add to the paperwork providers must contend with.

Prior authorization is widely used by Medicare Advantage plans. Many insurance companies hire technology firms to make prior authorization decisions for their Medicare Advantage plans.

Pilots are a key way that Medicare improves its services. Medicare tests changes on a small number of people or providers to see whether they should be implemented more broadly.

The six states participating are Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington. The 14 services that require prior authorization during this pilot include steroid injections for pain management and incontinence-control devices. The pilot ends December 2031.

If the Centers for Medicare & Medicaid Services, which administers Medicare, deems the pilot successful, the Department of Health and Human services could expand the program to include more procedures and more states.

An Extra Hurdle for Providers

This pilot isn’t changing the rules for what traditional Medicare covers. Instead, it adds an extra hurdle for medical providers before they can administer, for example, arthroscopic treatment for an osteoarthritic knee.

If Medicare issues a denial rather than authorizing the service, the patient goes without that treatment unless their provider files an appeal and prevails.

Medicare has hired tech companies to do the work of denying or approving prior authorization requests, with the aid of artificial intelligence.

Many of these are the same companies that do prior authorizations for Medicare Advantage plans.

The government pays the companies a percentage of what Medicare would have spent on the denied treatments. This means companies are paid more when they deny more prior authorization requests.

Medicare monitors the pilot program for inappropriate denials.

‘Low Value’ Treatments Targeted

Past research has shown that when insurers require prior authorization, the people they cover get fewer services. This pilot is likely to reduce treatments and Medicare spending, though how much remains unknown.

The Centers for Medicare & Medicaid Services chose the services targeted by the pilot because there is evidence they are given excessively in many cases.

If the program denies cases where a health service is inappropriate, or of “low value” for a patient’s health, people enrolled in traditional Medicare could benefit.

But for each treatment targeted by the pilot, there are some cases where that kind of health care is necessary.

If the program’s AI-based decision method has trouble identifying these necessary cases and denies them, people could lose access to care they need.

The pilot also adds to the paperwork that medical providers must do. Paperwork is already a major burden for providers and contributes to burnout.

AI’s Role

No matter how the government evaluates prior authorizations, we think this pilot is likely to reduce use of the targeted treatments.

The impact of using AI to evaluate these prior authorizations is unclear. AI could allow tech companies to automatically approve more cases, which could speed up decisions. However, companies could use time saved by AI to put more effort into having people review cases flagged by AI, which could increase denials.

Many private insurers already use AI for Medicare Advantage prior authorization decisions, although there has been limited research on these models, and little is known about how accurate AI is for this purpose.

What evidence there is suggests that AI-aided prior authorization leads to higher denial rates and larger reductions in health care use than when insurers make prior authorization decisions without using AI.

Winners and Losers

Any money the government saves during the pilot will depend on whether and how frequently these treatments are used inappropriately and how aggressively tech companies deny care.

In our view, this pilot will likely create winners and losers. Tech companies may benefit financially, though how much will depend on how big the treatment reductions are. But medical providers will have more paperwork to deal with and will get paid less if some of their Medicare requests are denied.

The impact on patients will depend on how well tech companies identify care that probably would be unnecessary and avoid denying care that is essential.

Taxpayers, who pay into Medicare during their working years, stand to benefit if the pilot can cut long-term Medicare costs, an important goal given Medicare’s growing budget crisis.

Like in Medicare Advantage, savings from prior authorization requirements in this pilot are split with private companies. Unlike in Medicare Advantage, however, this split is based on a fixed, observable percentage so that payments to private companies cannot exceed total savings, and the benefits of the program are easier for Medicare to quantify.

In our view, given the potential trade-offs, Medicare will need to evaluate the results of this pilot carefully before expanding it to more states – especially if it also expands the program to include services where unnecessary care is less common.

Grace Mackleby, PhD, is a research scientist of Health Policy and Economics at the University of Southern California. She is also a visiting scholar at the University of Utah Department of Population Health Sciences in Salt Lake City.

Jeff Marr, PhD, is an Assistant Professor of Health Services, Policy, and Practice at Brown University. His current work focuses on Medicare, prior authorization, and the use of AI in healthcare. 

This article originally appeared in The Conversation and is republished with permission.

Medicare Plans to End Most Telehealth Coverage Soon

By Crystal Lindell

Telehealth access was greatly expanded during the COVID-19 pandemic, but that expansion is slated to end this month for many older patients. Medicare is planning to end most coverage for telehealth appointments as of January 31, 2026.

There are some exceptions to the new policy. Telehealth appointments for those living in a rural area or seeking care in a rural area will still be covered. So will appointments for monthly home dialysis for end-stage renal disease; appointments for acute stroke; and appointments for behavioral health disorders.

The new policy only applies to Original Medicare plans. Medicare Advantage Plans may still cover telehealth appointments.

It’s baffling that this type of policy is being implemented for Medicare patients at all, seeing as how most people on Medicare are senior citizens — a demographic that is more likely to have mobility issues as well as a higher risk of falls.

The American Medical Association is calling on the federal government to make telehealth coverage permanent ahead of this month’s deadline. Congress has repeatedly extended the telehealth flexibilities for Medicare patients, but often at the last moment. The AMA says the constant procrastination creates uncertainty for millions of patients and their physicians.

“As the current waiver deadline approaches, Congress must finally act decisively to prevent a disruptive and abrupt halt to the expanded telehealth services that have improved care continuity, chronic disease management, and access for rural and underserved communities,” said AMA President Bobby Mukkamala, MD.

The AMA says telehealth offers the potential for long-term savings through early medical intervention, improved chronic disease management, and reduced use of expensive emergency care and inpatient services. Telehealth also has higher appointment completion rates and reduces hospital readmissions. In short, it helps our complex healthcare system work more efficiently and at a lower cost. 

“Now is the time for lawmakers to secure innovation, modernize care delivery, and protect access to telehealth for all Medicare beneficiaries by passing comprehensive, forward-looking reform,” the AMA said.

Speaking from personal experience, I am reminded of the time my grandma fell on the ice in front of her home a few years ago and broke her hip. The injury led to a months-long recovery process that included an extended stay at a rehabilitation facility. Aside from how inconvenient the entire episode was, it was also an extremely painful injury for her to endure.

Today, we limit how often she leaves the house to reduce the risk of her falling again. And we are especially cautious whenever the temperatures drop low enough to create icy patches on the ground.

Thus, whenever possible, we opt for telehealth appointments to keep grandma safe. Aside from reducing her fall risk, they also lower the risk of her being exposed to viruses at an in-person doctor’s office.

It seems like common sense that seniors in particular would have easy access to telehealth services, and my hope is that Congress will act and extend that access before the deadline. 

Hip Pain Has Many Causes and Most Don’t Require Surgery

By Charlotte Ganderton and Joshua Heerey

You can feel hip pain at any stage of life, including childhood, young adulthood and the middle years.

This can come as a surprise; since many people associate hip pain with old age. It can strike fear into the hearts of those in their 40s or 50s, who may suddenly wonder if old age – or even a hip replacement – may be on the horizon much sooner than expected.

The good news is only a minority of people with hip pain will have something medically concerning or actually need surgery. Surgery should only be considered after doing a comprehensive rehabilitation exercise program.

There are lots of complex underlying reasons for hip pain, and there may be plenty you can do before you start jumping to conclusions about needing surgery.

Causes of Hip Pain

In young boys and men, a condition known as femoroacetabular impingement syndrome is a common cause of hip pain. This is particularly true for those who play sports (such as soccer) where you need to change direction quickly and often.

This condition is caused by a bigger hip ball (also known as the femoral head) or the hip socket (the acetabulum). This may cause pain at the front or side of the hip. The pain may get worse during movements that involve the knee coming towards the chest (such as a squat) or trending across the middle of the body (such as sitting cross-legged).

In young girls and women, hip dysplasia is particularly common. This happens when the hip socket does not fully cover the ball of the joint. The hip can move too much, and may cause pain at the front, side or back of the hip.

However, excessive hip movement can also be caused when the connective tissue (such as the ligaments and hip capsule) get too elastic or stretchy.

Some people – such as performing artists, yogis and swimmers – may thrive on having more mobility for their artistry and sporting pursuits, but they need to be strong enough to control their excessive motion. Because people with increased mobility are at risk of injury, it is important to maintain hip muscle strength to support the hip joint.

In middle-aged adults and older people, the most common causes of hip pain are osteoarthritis and gluteal tendinopathy.

People with osteoarthritis often experience hip pain and stiffness, and may find it hard to reach down and put on shoes and socks.

People with gluteal tendinopathy might experience pain on the outside of their hip and have problems with lying on their side, climbing stairs or standing on one leg.

My Hip Hurts. How Worried Should I Be?

Well, it’s fundamentally about quality of life.

Does your hip pain make it hard to do social or community activities, perform daily tasks, or stay active? If so, then yes – you’re right to be concerned about your hip pain.

However, most hip conditions can be well managed with non-surgical treatments, such as exercises or stretches prescribed by a physiotherapist, doctor or other health-care professional. You may find you’re soon back to taking those long strolls in the park.

Whether your hip is too stiff or too mobile, start by seeking a thorough clinical examination from a trained and registered doctor or healthcare professional (such as a physiotherapist).

They may ask you to get some scans to help diagnose the cause of your hip pain. In most cases, an X-ray is used to understand the shape of the bones that form the hip joint and check for osteoarthritis.

In some people, an MRI is ordered to get a more detailed understanding of the different components of the hip joint. However, it is important to remember something might show up on an MRI even in people without pain.

Treatment for Hip Pain

Hip pain can often be managed with or without surgery.

If you do end up needing surgery, it’s worth knowing there are lots of different types of surgical treatments. The most common are hip arthroscopy (keyhole surgery) and hip replacement. For many people, though, non-surgical treatments are effective.

These might include adjusting how you exercise or do sport; learning about how to manage symptoms; and muscle strengthening exercises.

In most cases, it’s recommended to try non-surgical treatments for at least three months to see if they help reduce pain and improve hip function before considering surgery.

Whatever you do, stay active. And remember strong bum muscles are important to maintaining healthy hips, so try to find ways to keep your glutes strong.

Charlotte Ganderton, PhD, is a Senior Lecturer in Physiotherapy at RMIT University in Australia. She has received numerous awards for her research and has published papers and presented at national conferences in the musculoskeletal management of the hip and shoulder. 

Joshua Heerey, PhD, is a Physiotherapist and Research Fellow at La Trobe University in Australia. He has published numerous articles examining the diagnosis and treatment of intra-articular hip conditions and is a current member of the International Hip-Related Pain Research Network and Young Athlete’s Hip Research Collaboration.

This article originally appeared in The Conversation and is republished with permission.

Could PEMF Therapy Recharge Your Health?

By Madora Pennington 

I tend to be skeptical of any health treatment that sounds a bit “woo-woo.” After all, I don’t want to waste my resources on something that doesn’t work or might only be placebo.

But after experiencing so much benefit from stimulating my vagus nerve with a neuromodulation device, I wondered what other bioelectric medicine I could benefit from.

Perhaps you have heard of PEMF. It stands for pulsed electromagnetic field therapy. Like a TENS, ultrasound, or vagus nerve stimulator, it seeks to treat the body using electric currents.

Most PEMF devices are a mat for laying on, or sometimes a metal coil that is held or placed on an area of the body. A PEMF sends magnetic energy through the body or part of it.

Similarly, the depression treatment Transcranial Magnetic Stimulation (TMS) uses high intensity magnetic pulses to penetrate the skull to shift the brain out of states like depression, anxiety, or pain.

PEMF technology has been around since at least the 1970s. It’s first FDA approval came in 1979 for the treatment of non-healing bone fractures.

PEMF therapy works because the body responds to external forces. For example, bones get stronger from stress (think tennis or running), which triggers an electrical charge in the body that causes bone remodeling.

The pulsating low magnetic frequency of PEMF has a positive effect on cellular and biophysical systems, beyond just bones. A damaged or unhealthy cell may have its electrical charge disrupted. PEMF treatment increases cellular energy and improves blood flow, accelerating cell regeneration and tissue repair, acting as a sort of battery charger to cells.

Because collagen responds to forces like bones do, PEMF therapy helps tendons, ligaments, and wounds heal. It can also reduce low back pain and pain from osteoarthritis. Sessions on a PEMF can even increase cartilage, the cushioning tissue in joints.

I purchased the Hoolest MiniMax PEMF because I liked their vagus nerve stimulator. This is the only PEMF device I have tried, so I can’t compare it to others.

The Hoolest PEMF aims to be a clinical level device for the home user. Unfortunately, the MiniMax is not inexpensive, and costs thousands of dollars.

The founder of Hoolest says it takes powerful machinery to put energy through the entire body.

“A PEMF can activate and strengthen the entire network of the nervous system at once, while a vagus nerve stimulator takes smaller areas, just one section,” Nick Hool told me.

Hool advises using it frequently. Like exercise, it takes consistent application to get the most benefit.

My PEMF is bulky and noisy, making weird sounds like an MRI, another magnetic technology. Nonetheless, it is deeply soothing and relaxing and quickly became part of my daily routine.

Placing the coil on old injuries feels just wonderful. After some weeks of using it, my tolerance for exercise increased because the PEMF reduced post-exercise aches and soreness. I noticed I was sleeping very deeply. Overall, my mood was consistently optimistic and relaxed.

On Thanksgiving, a few of my guests took turns spending a half hour on my PEMF mat, after I jokingly promised it would cure anything. All said they felt deeply relaxed from it into the next day.

For the chronically ill, stimulating the body with magnetic pulses may be particularly helpful in ways that medications or surgeries are not. The pulsating magnetic frequencies of a PEMF promote homeostasis, the ideal state of balance in the body.

In the aftermath of severe illness or injury, symptoms can linger when the body is not properly regulating inflammatory processes. Immune cells can become inappropriately activated. All of this prevents tissue healing, which can result in chronic pain.

Time spent on a good PEMF device can re-regulate these off-kilter inflammatory and immune responses. This may clear up brain fog and alleviate chronic fatigue.

In the case of chronic pain, a PEMF may improve faulty signals that are transmitting too many pain messages to the brain. A PEMF device can also stimulate deeper branches of the vagus nerve that external stimulators applied to the skin cannot reach.

PEMF devices vary wildly in their specifications and so does their effectiveness. Studies often comment on the lack of uniformity in PEMF devices, which makes studying their results less consistent. Standard PEMF protocols would make studies more reliable.

Most insurers do not cover PEMF therapy, and consider it “experimental, investigational, or uproven,” although some specific FDA-approved uses, such as bone healing, might be exceptions.

Pregnant women and growing children should not use a PEMF. People with implanted devices like pacemakers should not use a PEMF, as it may make them malfunction.