Stanford Pain Medicine

10/20/2025

Up to 60% of people with cancer experience pain that isn’t adequately managed—often because they lack access to comprehensive treatments.

What’s new: A Stanford-led team tested Cancer Pain 101, a single 90-minute telehealth session that integrates pain neuroscience, pharmacology, and behavioral strategies.

What patients said:
•“This class gave me tools to better manage my pain—and to find help if I need it.”

•“The class presented new information about pain management and the types of pain cancer can cause.”

•“For someone new to cancer care, this is good information. I’d recommend it early in treatment.”

Zoom sessions worked: Participants valued the virtual format (“I’m all about telehealth—it’s just easier and more convenient”) and said the class length “wasn’t too long, wasn’t too short.”

The takeaway: A single online class helped patients feel less helpless, more informed, and more confident talking with their doctors about pain and medication—suggesting that brief, telehealth-based education could fill a critical gap in cancer pain care.

Full paper: https://bit.ly/4he9eFc

10/16/2025

When women’s pain is acknowledged and studied, care improves for everyone.

10/09/2025

There isn’t one single test for Complex Regional Pain Syndrome. Instead, doctors use:

•Your story of how and when the pain started
•A physical exam
•The Budapest Criteria—a checklist of symptoms pain doctors use
•Nerve block tests that can help pinpoint the pain source
•Special imaging scans like MR neurography that show tiny nerve changes. For example, Stanford researchers have used magnetic resonance neurography (MRN) to detect nerve abnormalities, as shown in Figure 1 from a 2021 study published in Frontiers in Pain Research.

Learn about risk factors, treatments, and more. https://stan.md/4mBaELS

10/09/2025

The Gate Control Theory of Pain provides a framework for understanding how pain is processed—and how we can manage it. Here are 4 examples of it in action:

•Rubbing or shaking works: Touching or moving an injured area sends signals to your spinal cord that can temporarily reduce pain. Example: rubbing a stubbed toe or bumped elbow.

•Water helps too: Running water over a sore spot can activate touch fibers and make pain feel less intense. Example: holding your hand under cold water after a minor burn.

•Kisses can reduce pain: Kissing an injury can help because it activates touch fibers and adds a positive emotional boost. Example: a gentle kiss on a scraped knee.

•TENS devices use the same idea: These small machines send gentle electrical pulses to activate touch fibers and reduce pain. Example: using a TENS pad on a sore shoulder after exercise.

Mechanical interventions like rubbing, shaking, or other forms of tactile stimulation modulate pain signaling at the spinal cord level rather than directly at the site of injury.

10/08/2025

A recent study led by Dr. Ken Weber, Dr. Anne Baker, and colleagues examined the spinal cord in people with fibromyalgia, some of whom take opioids and some who don’t.

•What they found: People taking opioids had slightly smaller gray matter in parts of the spinal cord. The size of this gray matter was linked to pain levels, how much pain affected daily life, and tolerance to cold pain.

•Why it matters: These results suggest that long-term opioid use may be connected to changes in the spinal cord related to pain. Understanding these changes could help researchers learn more about how chronic pain and treatments affect the nervous system.

Full paper: https://bit.ly/46IZm2D

10/07/2025

The evidence supporting cannabis for chronic pain management is limited, and more research is needed to understand its potential role.

•Limited evidence: While cannabinoids are known to interact with brain receptors involved in pain relief, well-controlled studies showing significant benefits for chronic pain are scarce. Some studies suggest short-term relief for neuropathic pain, but larger population studies, like one in Australia, found no major benefit.

•Research challenges: Due to cannabis being classified as a Schedule 1 drug, conducting thorough studies is challenging. Federal regulations make research cumbersome, limiting our understanding of how cannabis may impact chronic pain management.

•Patient outcomes: Data from observational studies indicates that patients using cannabis before seeking treatment tend to have worse outcomes, with limited improvement over time. However, these findings are based on observational data and are subject to several limitations.

•The need for rescheduling: Dr. Sean Mackey advocates for rescheduling cannabis to a Schedule 2 or 3 drug to make it easier to study and determine its true effectiveness in pain management.

10/02/2025

New 3-year data from the RESTORE trial show cognitive functional therapy (CFT) for chronic low back pain led to durable functional gains and modest pain changes.

Dr. Sean Mackey notes the results are promising but highlights caveats around study design and follow-up. He says more research is needed before CFT can be broadly adopted.

Personalized cognitive functional therapy provides sustained symptom improvement at 3 years for patients with chronic low back pain, a phase 3 follow-up study suggests.

09/30/2025

Nearly 1 in 3 Americans will face chronic pain, yet no two people experience it the same way.

In this new episode of The People’s Pharmacy, Stanford’s Dr. Sean Mackey explains:

•How new FDA opioid rules could affect patients

•What non-drug and medication options really help

•Why pain is personal

🎧 Show 1445: Your Brain on Pain — Why Chronic Pain Changes Everything

Pain is a subjective, individual experience. Relieving pain, especially chronic pain, calls for personalizing the treatment.

09/26/2025

Supplements and chronic pain: What does the research say?

Some studies suggest possible benefits for:

•Acetyl-L-Carnitine (energy for cells; studied in diabetic nerve pain)

•Alpha Lipoic Acid (antioxidant; may ease nerve pain, but can upset the stomach)

•Vitamin C (may reduce risk of nerve pain after surgery)

•Fish Oil (may lower inflammation and pain, but can thin blood)

•Creatine (linked to strength; small studies suggest benefits in fibromyalgia)

09/25/2025

fMRI of the spinal cord provides insights into pain processing, sensorimotor function, and autonomic control. Manual segmentation of spinal cord EPI data is time-consuming and prone to variability.

What’s new: EPISeg is a deep learning model for automatic spinal cord segmentation on gradient-echo EPI scans.

•Trained on a large, multi-center dataset with ground-truth segmentations.

•Demonstrates improved accuracy and robustness against motion, susceptibility, and signal drop-out artifacts.

•Open-source and integrated into the Spinal Cord Toolbox for broad research use.

Why it matters: Automated, high-quality segmentation can streamline spinal cord fMRI workflows, reduce inter-rater variability, and accelerate research into pain and sensorimotor function.

Full paper: https://bit.ly/4mAcTyc

09/25/2025

Cannabis use is on the rise, but scientists are still figuring out how well it works for pain. Research shows it may ease muscle stiffness for people with multiple sclerosis, but there’s little evidence it helps with everyday work-related pain. Experts also warn that cannabis can slow reaction time and affect attention, so people in safety-sensitive jobs—like drivers or construction workers—should be especially cautious.

Read the paper: https://bit.ly/46Si8o2