FDA Clears Ear Device for IBS Pain

By Pat Anson, PNN Editor

The U.S. Food and Drug Administration has cleared for marketing the first medical device to treat abdominal pain in patients 11-18 years of age with irritable bowel syndrome (IBS).

The IB-Stim device is made by Innovative Health Solutions and is only available by prescription. It uses neuromodulation to stimulate cranial nerves around the ear to provide relief from IBS, a condition affecting the large intestines that causes abdominal pain and discomfort during bowel movements.

The battery powered device is placed behind the patient’s ear — much like a hearing aid — and emits low-frequency electrical pulses that disrupt pain signals. It is intended for use up to three consecutive weeks.  

“This device offers a safe option for treatment of adolescents experiencing pain from IBS through the use of mild nerve stimulation,” said Carlos Peña, PhD, director of the FDA’[s Office of Neurological and Physical Medicine Devices.

The FDA reviewed data from a placebo controlled study published in The Lancet that included 50 adolescent patients with IBS. During the study, patients were allowed to continue using medication to treat their abdominal pain. Most had failed to improve through the use of drugs.

IB-Stim treatment resulted in at least a 30% decrease in pain after three weeks in 52% of the treated patients, compared to 30% of patients who received the placebo. Six patients reported mild ear discomfort and three had an allergic reaction caused by an adhesive at the site of application.

IMAGE COURTESY OF INNOVATIVE HEALTH SOLUTIONS

Innovative Health Solutions is not disclosing any details about the potential cost of an IB-Stim or where it will be available.

“We are still working to finalize our pricing structure,” Ryan Kuhlman, National Director of Innovative Health Solutions, said in an email. “There are many factors that go into the final contract price with a hospital and will likely vary from hospital to hospital. We do want to make this treatment available and affordable as we work towards favorable insurance coverage.”  

The FDA reviewed the IB-Stim through a regulatory pathway for low- to moderate-risk medical devices. Clearance of the device creates a new regulatory classification, which means that similar devices for IBS may be cleared if they are substantially equivalent to an approved device. Similar ear devices have been cleared by the FDA to treat symptoms of opioid withdrawal and for use in acupuncture.

IBS is a group of symptoms that include chronic pain in the abdomen and changes in bowel movements, which may include diarrhea, constipation or both. A 2018 study found that hypnosis relieves pain in about a third of IBS patients.

The Hidden Benefits of Glucosamine

By Pat Anson, PNN Editor

Do you take glucosamine supplements to reduce joint pain and stiffness? You’re not alone if you do. According to a 2007 survey, nearly 20 percent of U.S. adults take glucosamine to prevent or treat pain from osteoarthritis, back pain and other conditions.

The evidence to support the use of glucosamine for joint pain is thin, but a large new study in The BMJ suggests regular use of the supplement can reduce the risk of cardiovascular disease.

Researchers at Tulane University analyzed 7 years of extensive health data for almost half a million adults aged 40 to 69 enrolled in the UK Biobank study. Those who regularly took glucosamine were about 15% less likely to develop heart disease or have a stroke.

Glucosamine occurs naturally in the fluid around joints and plays an importantly role in building cartilage. Glucosamine is extracted from shellfish and is often combined in supplements with chondroitin, a similar substance that is also found in joints.

People who took glucosamine in the BMJ study were more likely to be women, older, more physically active, have healthier diets and take other supplements.

Over the course of seven years, 2.2% of those who did not use glucosamine had a heart attack or stroke, compared to 2.0% of people who did use glucosamine. People who used glucosamine were also less likely to die from a heart attack or stroke, 0.5% vs. 0.7% of those who didn’t use the supplement.

The difference doesn’t appear to be significant, but when adjusted for risk and other factors, it means that glucosamine users had a 22% lower risk of dying from a heart attack or stroke.

For smokers, the benefits of regular glucosamine use were even greater. They had 37% less risk of having coronary heart disease compared to smokers who didn’t use the supplements.

Researchers didn’t establish the reason why glucosamine lowers the risk of cardiovascular disease (CVD), but they believe the supplements help reduce inflammation – one of the main factors involved in the development of heart disease, as well as chronic pain.

“Several potential mechanisms could explain the observed protective relation between glucosamine use and CVD diseases. In the National Health and Nutrition Examination Survey (NHANES) study, regular use of glucosamine was associated with a statistically significant reduction in C reactive protein concentrations, which is a marker for systemic inflammation,” researchers reported. “Other mechanisms might also be involved, and future investigations are needed to explore the functional roles of glucosamine in cardiovascular health.”

The UK’s National Health Service (NHS) downplayed the study findings, pointing out the cardiovascular benefits of glucosamine are “quite small.”

“If you want to reduce your risk of having a heart attack or stroke, it would be much better to concentrate on living a healthy lifestyle, rather than paying for glucosamine supplements,” the NHS said.

Magic Mushrooms, Psychedelics and Chronic Pain

By Roger Chriss, PNN Columnist

The recent news that Denver has decriminalized “magic” mushrooms is the latest sign of growing interest in the use of psychedelics. Whether it’s microdosing mushrooms to stimulate the mind or using them to treat depression and chronic pain, psychedelic drugs are having a moment.

Magic mushrooms are any of roughly 200 different types of fungi that produce psilocybin, a hallucinogenic substance. Other psychedelics include LSD, DMT, ayahuasca and ibogaine. For reasons of chemistry and cultural baggage, DMT is generally avoided, LSD is used with extra caution and psilocybin is getting the most attention in clinical studies.

Preliminary research has found positive outcomes for psychedelic therapy in smoking cessation,  anxiety, post-traumatic stress disorder and refractory depression. And there are promising findings on psychedelics for cluster headaches and phantom limb pain.

A 2015 review in the Journal of Psychoactive Drugs reported that for patients with cluster headaches, psilocybin and other hallucinogens “were comparable to or more efficacious than most conventional medications.”  

In a 2006 Neurology review, researchers interviewed 53 cluster headache patients who used LSD or psilocybin. Most reported success in stopping cluster attacks and extending periods of remission.

And a 2018 Neurocase report described positive results for one patient with intractable phantom pain who combined psilocybin with mirror visual-feedback.

Obviously, these studies are very preliminary. Patient self-reports on drug use outside of clinical settings have limited value as evidence of efficacy. And case reports are by definition too small-scale to generalize from.

Fortunately, more clinical trials are underway for psilocybin and LSD. Last year the FDA approved a “landmark” psilocybin trial for treatment-resistant depression. And the Multidisciplinary Association for Psychedelic Studies is also working to promote robust clinical research.

Of course, psychedelics are not without risks. As described in detail in the book DMT: The Spirit Molecule, patients need to be screened and monitored before, during and after psychedelic therapy.

Michael Pollan, author of “How to Change Your Mind”, told The New York Times that psilocybin has risks “both practical and psychological, and these can be serious.”

There are also risks of conflating the pop culture phenomenon of microdosing to clinical benefits obtained under medical supervision.

The “betterment of healthy people” through microdosing is enthusiastically endorsed in books like “A Really Good Day” by Ayelet Waldman. But a 2018 placebo-controlled study on LSD microdosing found no “robust changes” in perception, mental acitivty or concentration.

The microdosing trend could stymie serious research and bias public opinion about psychedelics — just as it did in the 1960’s.

The potential for psychedelic therapy in the management of chronic pain disorders is two-fold. First, psychedelics may represent a safe and effective way to manage otherwise intractable disorders like cluster headaches and phantom limb pain. Second, psychedelics may help address the depression, PTSD and anxiety that often contribute to or accompany such disorders.

It is to be hoped that more research on psychedelics comes quickly.

Roger Chriss lives with Ehlers Danlos syndrome and is a proud member of the Ehlers-Danlos Society. Roger is a technical consultant in Washington state, where he specializes in mathematics and research.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Mindfulness Is More Than Yoga

Barby Ingle, PNN Columnist

For years I’ve used mindfulness meditation techniques to help with my chronic pain. So imagine my surprise last week as I was watching the Pain Management Best Practices Inter-Agency Task Force meeting and a practitioner on the panel said yoga and mindfulness are essentially the same thing.

I’ve never done yoga as part of my mindfulness meditation. But it made me start to wonder. Have I been doing mindfulness wrong for years?

A quick Google search showed me there are more than 25 mindfulness activities. Yoga was one of the items on the list, but not everyone doing yoga is doing it for mindfulness. Most use it for physical exercise.

Another practitioner on the task force said that mindfulness is not a treatment by itself and that it is typically done in conjunction with other modalities. I totally agree. There are many group and individual activities that use mindfulness to reduce stress, anxiety, depression and pain.

Mindfulness is just one form of self-care that I use do to help manage the symptoms of living with chronic conditions. By itself, mindfulness is not enough to sustain me, but in conjunction with other treatments I find it helpful.  

I personally like individual mindfulness activities. Some of the activities are really short and some take up to an hour. Depending on what I need, I choose one that best suites me in the moment. Some of the activities I use for improving my life include virtual reality, self-compassion, reviewing my "I Am" list, meditation, 5 senses exercise, breathing exercises, music therapy and aroma therapy.

If you have trouble practicing mindfulness alone, one of the group activities is known as the FAKE plan, which involves about 8 members meeting for 2 hours every week for 12 weeks. The first portion of each session is devoted to a short mindfulness exercise and discussion, and each week is dedicated to a specific type of mindfulness exercise.

This is great for patients with social anxiety disorder but can also be helpful for others who want to work on their social skills through group mindfulness activities.  

Another mindfulness exercise that I found in my Google search (but have not yet tried) involves staring at a leaf for 5 minutes. A leaf is like a fingerprint or snowflake -- no two are the same. You can focus on the leaf’s colors, shape, texture and patterns. This type of activity brings you into the present and helps align your thoughts.

When I am not able to perform the physical or cognitive tasks I want to because of physical pain, I can get situational depression. For me, this is the best time to use my mindfulness activities. One study identified three ways mindfulness helps when you are depressed:

1.  Mindfulness helps people learn to be present in the moment, take stock of their thoughts and feelings, and choose an appropriate response rather than get caught up in negative emotions.

2.  Mindfulness teaches people that it’s okay to say “no” to others, which helps them balance their own lives and enhance self-confidence.

3.  Mindfulness allows people to be present with others, making them more attentive to their relationships, aware of their communication problems and more effective in relating to others.

These are important tools that can help chronic pain patients better manage their lives. Mindfulness activities help clear your mind of worry about the past or future and allow you to focus on the present.

Whether you are using mindfulness for anger, depression, chronic pain, anxiety or just for overall mental health -- it is important to keep an open mind. I know that is easier said than done when you are in severe pain. But the more you practice mindfulness the easier and more useful it becomes.

Can mindfulness cure you? No. Its purpose is to relax and help put life into perspective. If you are angry and distressed, that’s okay. I go there too sometimes. I use mindfulness to live in the moment and manage my emotions so that I am better able to manage my physical pain.

Barby Ingle lives with reflex sympathetic dystrophy (RSD), migralepsy and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain Foundation. She is also a motivational speaker and best-selling author on pain topics. More information about Barby can be found at her website. 

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

‘Space Pants’ Help Patients Walk Again

By Steve Weakley

Specially designed “space pants” worn by astronauts to regulate their body temperature are helping patients with Peripheral Artery Disease (PAD) walk and exercise again with less pain.

More than eight million Americans suffer from PAD -- a narrowing of peripheral arteries in the legs that can cause severe pain and cramping after a short walk or even just climbing a flight of stairs.

“I have patients that have trouble going to their mailbox,” said Bruno Roseguini, PhD, an assistant professor in the Department of Health and Kinesiology at Purdue University. “These patients, in order to avoid that pain, become very inactive. So, this is a vicious cycle that leads to more impairment and more functional decline over time.”

PURDUE UNIVERSITY

To get PAD patients moving again, Roseguini and his research team turned to NASA and the elastic space pants worn by astronauts.  Woven into the pants is an elaborate tubing system that circulates warm water and helps keep the astronauts’ body temperatures normal in a weightless environment. 

Researchers modified the pants for a clinical study of PAD patients and found they were able to lower blood pressure and increase circulation in their legs. Patients who wore the pants for 90 minutes every day for eight weeks reported less pain and more mobility.

"It's like putting your legs in a hot tub without getting wet," says PAD patient Stephen Scott, who is now able to stand longer and walk longer distances. "It feels good."

“Based on our initial findings, it is conceivable that repeated exposures to heat therapy might enhance the ability of the arteries in the legs to vasodilate” Roseguini said. “What that means is there would be more blood flow and greater oxygen delivery to calf muscles during exercise, and we anticipate this will prolong the time they can walk before they feel pain.”

Roseguini explains how the pants work in the video below:

Roseguini calls physical exercise the “gold standard” for treating PAD, even if many patients choose other routes of relief.  Some have stents surgically inserted into their leg arteries, but they can narrow without exercise and may have to be replaced every few years. Medication and dietary changes can also help manage PAD, for which there is no cure.

“Exercise is painful for these patients and leg pain is one of the main reasons for why most of these patients do not adhere to structured exercise programs,” said Roseguini. “Heat therapy, on the other hand, is not painful. If anything, heat therapy might actually reduce leg pain, so the patients see that as a treatment they would potentially adhere to.”

Studies show heat therapy can also improve the health of blood vessels and help muscles recover after an injury.

“Heat therapy is a powerful tool for rehabilitation,” says Roseguini, who hopes to develop a portable battery-powered pump that PAD patients can wear without being tethered to an electric outlet. “I want the patients to be able to receive the therapy while walking and performing their daily living activities, such as going to the grocery store.”

Pets Help Take Our Minds Off Pain

By Pat Anson, PNN Editor

Pets make good companions, keep their owners physically active and help us enjoy life. But did you know that pets can also help take our minds off pain?

That’s one of the findings from a new National Poll on Healthy Aging conducted by AARP and the University of Michigan Institute for Healthcare Policy. Researchers surveyed over 2,000 American adults aged 50 to 80, who answered a wide range of questions online about the health benefits of pet ownership.

Companionship, social connection and physical activity were positive side effects of pet ownership for many poll respondents.

People said their pets helped them enjoy life (88%), make them feel loved (86%), help reduce stress (79%), keep them physically active (64%) and help them cope with physical and emotional symptoms (60%), including taking their mind off pain (34%).

For those who said their health was fair or poor, pet ownership offers the most benefits. More than 70 percent of those older adults said their pet helps them cope with physical or emotional symptoms, and nearly half (46%) said their pets help distract them from pain.

"Relationships with pets tend to be less complicated than those with humans, and pets are often a source of great enjoyment," says Mary Janevic, PhD, an assistant research scientist at the U-M School of Public Health. "They also provide older adults with a sense of being needed and loved."

More than half of those who owned pets said they did so specifically to have a companion and nearly two-thirds said having a pet helps connect them to other people.

"We have long known that pets are a common and naturally occurring source of support," says Cathleen Connell, PhD, a professor at the U-M School of Public Health. “Although the benefits of pets are significant, social connections and activities with friends and family are also key to quality of life across the lifespan. Helping older adults find low cost ways to support pet ownership while not sacrificing other important relationships and priorities is an investment in overall mental and physical health."

While pets come with benefits, they can also bring concerns. Nearly one in five older adults (18%) said having a pet puts a strain on their budget. Some owners even put their animals' needs ahead of their own health.

"For people living on a fixed income, expenses related to health care for pets, and especially pets that have chronic health issues, can be a struggle. Older adults can also develop health problems or disabilities that make pet care difficult," said Janevic.

"More activity, through dog walking or other aspects of pet care, is almost always a good thing for older adults. But the risk of falls is real for many, and six percent of those in our poll said they had fallen or injured themselves due to a pet," said poll director Preeti Malani, MD. “At the same time, given the importance of pets to many people, the loss of a pet can deal a very real psychological blow that providers, family and friends should be attuned to."

More than half of older adults (55%) reported having a pet. Among pet owners, the majority (68%) had dogs, 48% had cats, and 16% had a small pet such as a bird, fish, or hamster.

Over half of pet owners (53%) reported that their pets sleep in their bed. Dog lovers are often told that’s a bad idea, but a recent study found an "overwhelmingly positive" response from owners who say they slept better with their dogs.

Mice and Mozart: Can Music Make Pain Meds More Effective?

By Pat Anson, PNN Editor

Wolfgang Amadeus Mozart is widely considered the most gifted and prolific composer in the history of classical music. Mozart composed over 600 symphonies, concertos and operas, and many remain popular two centuries after his death.

WOLFGANG AMADEUS MOZART

Were he alive today, Mozart would probably be flattered to learn that his music is being studied as a pain reliever.  And amused that some of his most devoted listeners are mice.

Music therapy won’t cure chronic pain, but there’s a growing body of evidence that it helps distract and alleviate pain and anxiety. Mozart’s “Sonata for Two Pianos” has been found to be particularly helpful in treating patients with epilepsy.

Researchers at the University of Utah took that theory a step further, to see if music can decrease pain and improve the effectiveness of ibuprofen and cannabidiol (CBD), the non-psychoactive compound found in marijuana.

"We know these drugs work without music but they can produce toxicity and adverse effects," said senior author Grzegorz Bulaj, PhD, an associate professor in medicinal chemistry at University of Utah Health. “The holy grail is to combine the right drug with this new paradigm of music exposure, so we do not need as much drug for analgesic effects."

‘Music is Like DNA’

Bulaj and his colleagues selected some of Mozart’s compositions and arranged them on a playlist for laboratory mice. That’s right, mice. Humans were not part of the study.

The playlist was made up of two faster-paced allegro sections separated by a slower adagio section — with “Sonata for Two Pianos” played multiple times. The goal was to “balance arousal” and “minimize any potential stress on the mice.”

"Music is like DNA. We had musicians analyze sequences of several Mozart pieces to optimize the playlist," Bulaj said. "This was exciting but challenging to integrate these musical analyses into neuropharmacology."

The mice were divided into two groups (five to eight mice in each group), with a control group exposed to ambient noise, while mice in the music group listened to the Mozart playlist three times a day for 21 days.

Both groups were given ibuprofen, CBD and two epilepsy drugs. The mice received one sub-optimal dose of each drug and then put through a series of inflammatory pain tests in the laboratory.

When combined with music, ibuprofen reduced inflammation in the mice by 93 percent compared to ibuprofen alone. Mice exposed to Mozart and CBD had a 70 percent reduction in inflammation compared to CBD with no music. Researchers say they were unable to evaluate the effectiveness of music with epilepsy drugs.

"There is emerging evidence that music interventions can alleviate pain when administered either alone or in combination with other therapies," said first author Cameron Metcalf, PhD, a research assistant professor in Pharmacology and Toxicology at University of Utah Health. "I was particularly excited to see reduced swelling in the inflammatory pain model."

According to Metcalf, medications currently available to treat inflammation do not show such a robust response. "It is exciting to think of what this might mean for the anti-inflammatory effects of music interventions and where the research may take us next," he said.

Mice hear at different frequencies than humans, and the effect of music volume or duration remains unclear. So is the type of music. Is Mozart a better pain reliever than Beyonce? We don’t know. Also unclear is whether any of these results can be duplicated in people. But Bulaj believes future studies should explore the pairing of music with pain relievers.

"If we could package music and other non-pharmacological therapies into mobile apps and deliver them with drugs and it works, it will be better than drugs alone," Bulaj said. "It is exciting to find new ways to improve pain treatments."

Mozart didn’t need an app or mice to figure that out. “Music, even in situations of the greatest horror, should never be painful to the ear but should flatter and charm it,” he wrote to a friend.

The study findings are published online in the journal Frontiers in Neurology.

FDA Takes a Bite Out of Nyloxin

By Pat Anson, PNN Editor

It’s fair to say that cobra venom isn’t high on the list of go-to analgesics for most chronic pain sufferers. But that hasn’t stopped Nutra Pharma from cashing in on the appeal of an exotic, non-opioid pain reliever.

The Florida company’s main product – Nyloxin – is a homeopathic-based medicine that contains a tiny amount of cobra venom, which supposedly contains compounds that block pain signals from reaching the brain. Like other homeopathic products, Nutra Pharma’s CEO says only a small amount of the active ingredient is needed to make Nyloxin sprays and gels effective.

“Our regular strength product is 70 micrograms per milliliter of cobra venom,” CEO Rik Deitsch told PNN. “Our product is based on over a hundred years of research utilizing cobra venom at these dilution levels.”

But a complaint filed last fall by the Securities and Exchange Commission raises doubts about Nutra Pharma claims that it had 1,300 cobra snakes on a Florida farm that it “milks” monthly for venom.

“Nutra Pharma never had a cobra farm, never had cobras, and indeed had never produced cobra venom,” the SEC said.

The only ones getting milked may be Nutra Pharma’s investors. The SEC complaint alleges Deitsch used manipulative insider stock trades and “a series of materially false or misleading press releases” to defraud investors out of nearly $1 million.

This week the U.S. Food and Drug Administration got into the act by sending a warning letter to Deitsch for illegally marketing unapproved products with false claims about their ability to treat chronic health conditions.  

“Today, we posted a warning letter to a company preying on patients who may be seeking alternative treatments for chronic pain, cancers, arthritis and autoimmune and neurological disorders. Health fraud scams like these are inexcusable,” FDA Commissioner Scott Gottlieb, MD, said in a statement.

They may be inexcusable, but they’ve been going on for years with little government oversight. Nutra Pharma’s multi-level marketing touts Nyloxin as “clinically proven to treat moderate to severe chronic pain.” and its website has dozens of glowing reviews from customers.  In a video on its YouTube channel, one customer even claims Nyloxin helped him become the first rheumatoid arthritis sufferer to climb Mt. Everest.   

The FDA commissioner says its time for deceptive marketing claims to end.

“One of our most important obligations is to protect consumers from those who would prey on them with bogus claims and fraudulent products. We’ve dedicated new resources to our enforcement work and I consider these activities the cornerstone of our consumer protection mission,” said Gottlieb. “We’re especially focused on those who would exploit Americans harmed by the opioid crisis with the false promise of products that can treat pain or addiction, but that offer no such benefit.”

It’s good that Gottlieb wants to protect consumers, but he fails to recognize that many Americans are turning to products like Nyloxin because they’re losing access to opioid therapy.  Denied the pain medication that most have safely used for years, patients are experimenting with alternative treatments, including some that are dubious or even fraudulent, such as compounded pain creams and cannabis skin patches.

PNN’s recent survey of over 5,800 patients found that 20 percent had tried medical marijuana or kratom for pain relief. Even more (26%) had used alcohol and a small number (4%) had turned to illegal drugs such as heroin. One in ten said they were getting prescription opioids from family and friends or buying them on the black market — which is being flooded with “Mexican Oxy” and other counterfeit pills laced with fentanyl.

Is it any wonder that people are buying Nyloxin? Or that Nutra Pharma is touting it as a “non-narcotic” and “safe” homeopathic solution to the opioid crisis? In a sense, policymakers have done all the marketing for them.

“I can tell you we have hundreds, if not thousands of people that have reduced or gotten off their opiates with Nyloxin,” said Deitsch, who intends to comply with the FDA request and continue selling Nyloxin. “We are answering the FDA warning letter. We are making the changes to the website and the claims they have asked us to make. But it is a great product and we stand by it.”

Are Sit-Stand Desks Overrated?

By Pat Anson, PNN Editor

You’ve probably seen commercials touting the health benefits of sit-stand desks. Experts say being able to stand occasionally – instead of sitting at an office desk all day -- helps prevent back pain, diabetes, high blood pressure, obesity and other chronic health conditions.

There may be some truth to that, but some of the health claims range from silly to the absurd.

“Sitting is more dangerous than smoking. We are sitting ourselves to death,” James Levine, MD, an endocrinologist at the Mayo Clinic, told the Los Angeles Times. “The chair is out to kill us.”

Is sitting really that dangerous? It is if you believe Australian researchers, who came to the eye-opening conclusion that sitting for one hour reduces life expectancy by 22 minutes. Their study was about people who watch a lot of television, but it is often cited by sit-stand desk manufacturers.

One desk manufacturer funded a study — which is mysteriously being promoted by the CDC — that looked into the psychological benefits of sit-stand desks. The study found that standing more often at work will not only relieve back pain, but make you feel healthier, happier and improve your self-esteem.

Minimal Health Benefits

Just how reliable is this industry-promoted research?

“There has been a great deal of scientific research about sit-stand desks in the past few years, but we have only scratched the surface of this topic,” says April Chambers, PhD, an assistant professor of bioengineering at the University of Pittsburgh’s Swanson School of Engineering. “I wanted to gather what we know so far and figure out the next steps for how can we use these desks to better benefit people in the workplace.”

Chambers and her colleagues reviewed 53 studies on sit-stand desks and published their findings in the journal Applied Ergonomics. Their research focused on the impact of the desks on behavior, physiology, psychology, work performance, discomfort and posture.

“The study found only minimal impacts on any of those areas, the strongest being changes in behavior and discomfort,” said co-author Nancy Baker, ScD, an associate professor of occupational therapy at Tufts University.

“There are health benefits to using sit-stand desks, such as a small decrease in blood pressure or low back pain relief, but people simply are not yet burning enough calories to lose weight with these devices,” added Chambers.

One of the biggest flaws in current studies is that most were done with young and healthy subjects who were asked to use the desk for a week or month at most. Researchers say it would be beneficial to perform longer studies with middle-aged or overweight workers to get a more accurate measure of the desks’ impact on cardiovascular health and weight loss.

Further study is also needed on desk height, monitor height, the amount of time standing, and the use of anti-fatigue floor mats to soften the blow of so much standing. 

“There are basic ergonomic concepts that seem to be overlooked,” said Chambers. “Many workers receive sit-stand desks and start using them without direction. I think proper usage will differ from person to person, and as we gather more research, we will be better able to suggest dosage for a variety of workers.”

Sit-stand desks range in price from inexpensive models for $179 to nearly $1,000 for motorized adjustable desks that come with settings for different users.

If you’re thinking of buying a sit-stand desk, a good place to start your research is online. In the YouTube video below, David Zhang rates some of desks he’s tried over the past year. David likes having a standing desk, but has doubts about their health benefits and says the desks do not replace the need for a good old-fashioned office chair.

Study: Alcohol Relieves Fibromyalgia Pain

By Pat Anson, PNN Editor

Another study is adding to a growing body of evidence that alcohol is an effective – yet risky – way to treat chronic pain.

Researchers at the University of Michigan surveyed over 2,500 patients being treated at a university pain clinic about their drinking habits, pain severity and physical function. Participants were also assessed for signs of depression and anxiety. About a third of the patients were diagnosed with fibromyalgia (FM), a poorly understood disorder characterized by widespread body pain, fatigue, insomnia, headaches and mood swings.

Researchers, who recently published their study in the journal Pain Medicine, found that patients who were moderate drinkers had less pain and other symptoms than those who did not drink alcohol.

“Female and male chronic pain patients who drink no more than 7 and 14 alcoholic drinks per week, respectively, reported significantly lower FM symptoms, pain severity, pain-related interference in activities, depression, anxiety and catastrophizing, and higher physical function,” said lead author Ryan Scott, MPH, of UM’s Chronic Pain and Fatigue Research Center.

“These findings suggest that chronic pain patients with a lesser degree of pain centralization may benefit most from low-risk, moderate alcohol consumption.”

According to the Mayo Clinic, moderate alcohol consumption for healthy adults means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

Of the study participants, over half reported use of opioid medication, which carries serious risks when combined with alcohol. Perhaps for that reason, participants in the UM study drank less alcohol than the general population.

“People with chronic pain may drink less due to the stigma and because they are being told not to drink while on pain medication,” says Scott.

Moderate drinkers with chronic pain were more likely to be white, have an advanced degree and were less likely to use opioids. They reported less pain, lower anxiety and depression, and higher physical function.

Researchers found that fibromyalgia patients who drank moderately reported decreased pain severity and depression, but alcohol had no effect on how widespread their pain was or other symptoms such as cramps, headache, fatigue, poor sleep and cognitive dysfunction.

Scott believes alcohol may stimulate the production of gamma-aminobutyric acid (GABA), a neurotransmitter in the central nervous system that reduces nerve activity. Alcohol and drugs such as gabapentin (Neurontin) that act on GABA typically have relaxing effects.

“Alcohol increases gamma-aminobutyric acid in the brain, which is why we could be seeing some of the psychiatric effects. Even though alcohol helped some fibromyalgia patients, it didn’t have the same level of effect,” said Scott. “You probably need much more GABA to block pain signals and that may be why we’re not seeing as high an effect in these patients.”

Over a dozen previous studies have also found that alcohol is an effective pain reliever. In a 2017 review published in the Journal of Pain, British researchers found “robust evidence” that alcohol acts as an analgesic.

“It could be a stepping stone to increased quality of life, leading to more social interactions,” says Scott. “Fibromyalgia patients in particular have a lot of psychological trauma, anxiety and catastrophizing, and allowing for the occasional drink might increase social habits and overall health.”