pain

Pain does not increase linearly with age; rather, the most pronounced increases occur before the age of 55. This is the main conclusion of a study published in the journal Nature Medicine, which included Spanish participation and analyzed data from more than six million people aged five to over 100 in 118 countries. Across all areas of the body, the prevalence of pain increased most sharply before age 55. Headaches and abdominal pain peaked at an earlier age, while back, hip, and knee pain continued to increase with age.

Women, particularly younger women, are disproportionately affected by painful conditions such as irritable bowel syndrome, endometriosis, menstrual migraines, fibromyalgia, osteoarthritis and neuropathic pain. A review published in Science summarises the latest advances in visceral and somatic pain, highlighting the impact of sex hormones, immunoneural interaction, the gut microbiota and endogenous analgesic circuits. These studies are beginning to explain why women experience more intense pain than men, paving the way for mechanism-based precision therapies. “Women are desperately hoping for concrete answers that can help dispel the common notion that ‘it’s all in your head’ when it comes to their conditions,” the authors note. The research forms part of a Science special issue on women’s health, which includes four further articles.

Chemotherapy-induced peripheral neuropathy is a side effect of platinum-based cancer treatments that affects more than 60 per cent of patients and causes pain, a burning sensation and numbness. The psychedelic compound psilocybin could help prevent it, according to researchers behind a study using mouse models published in Science. Two doses of psilocybin administered prior to treatment prevented peripheral neuropathy for up to six cycles of chemotherapy without reducing its anti-tumour effects. The author of another perspective article on this study, also in Science, states that “the challenge now is to translate this understanding of the underlying mechanisms into carefully designed clinical trials”.

Neuromuscular taping, or Kinesio taping, is widely used to relieve joint and muscle pain and improve range of motion. However, a meta-analysis published in the journal BMJ Evidence-Based Medicine concludes that it may not be as effective as previously thought. This adhesive tape may provide immediate or short-term benefits, but the current evidence is “highly uncertain”. The authors conclude that the lack of robust evidence, coupled with the potential for associated skin irritation, could limit its use in clinical practice. 

Tramadol is a painkiller prescribed for chronic pain and is considered safer than other opioids. A systematic review with meta-analysis that included 19 clinical trials with more than 6,500 people showed that, although it relieved pain, the effect was small and below what would be considered clinically effective. In addition, the analysis indicated that the drug is likely to increase serious adverse events, particularly cardiac events. Although an increased risk of some types of cancer was also detected, the authors question this effect due to the short follow-up period. ‘Given the limited analgesic benefits and increased risk of harm, the use of tramadol for chronic pain should be reconsidered, with preference given to safer alternatives and additional high-quality trials to clarify its risk-benefit profile,’ the researchers note in the study, published in BMJ Evidence Based Medicine.

Prenatal exposure to triptans—alone or in combination with other migraine medications—does not increase the risk of developmental disorders in children up to age 14, according to research published in Neurology. The study is based on data from more than 26,000 pregnancies in a national registry in Norway and includes autism spectrum disorders, language disorders, and attention deficit hyperactivity disorder, among other diagnoses.

A migraine treatment drug, ubrogepant, also reduces common non-headache symptoms that occur in the hours before a migraine, according to the results of a large phase III clinical trial published in Nature Medicine. The results suggest that this could be the first acute treatment for symptoms that occur before migraine and have a significant impact on daily life, such as dizziness, sensitivity to light and noise, and neck pain.

Chronic pain is a public health problem that affects almost one in six people in Spain, with very different origins and characteristics. Specialists in psychology and pain explain what it is, how it is treated, what consequences it has for those who suffer from it and how to learn to live with it.

People taking heartburn medications suffer more migraines and severe headaches, says a study published in Neurology: Clinical Practice. According to the authors, these observations are consistent with other studies that link migraine and headaches to the use of proton pump inhibitors (such as omeprazole), and the new study adds a correlation with the use of other types of antacids. The analysis is based on data from more than 11,800 adults between 1999 and 2004 in the United States. 

This week, Spain’s Ministry of Health launched a process to develop a Royal Decree on the medical use of cannabis, assuring that it will be "a rigorous measure based on the best scientific evidence available.” The goverment is conducting a public consultation until 4 March to gather the opinions of citizens, civil society organisations, professional associations and scientific societies. In this explainer, we attempt to answer the main questions that arise regarding the medical use of cannabis.