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    Managing Pain: What's Next, What Works

    Laughter is Good Medicine continued...

    Stuber says those children who laughed while watching the video during the cold-water test also released less of a pain-related stress hormone known as cortisol. She says those findings suggest that laughter somehow affects how the body perceives pain and more studies are needed to find out how it works.

    "In the future, watching humorous videos could be come a standard component of some medical procedures," says Stuber. "It's one of the few things that is effective, but isn't expensive."

    Stopping Pain in Its Tracks

    Another way doctors may be able to reduce the pain their patients endure after surgery could be to give them pain relievers before surgery, rather than after. Mark Lema, MD, PhD, chairman of the department of anesthesiology and pain medicine at Roswell Cancer Institute in Buffalo, N.Y., talked about new research that has shown giving patients pain medication several hours before surgery can not only reduce their pain after surgery, but also reduce the amount of anesthesia needed.

    Lema says the body responds to a surgical incision like any other cut or trauma, and the nerve endings swell and become more sensitive to pain as a defense mechanism. By giving pain relievers before the cut is made, doctors may be able reduce that painful response.

    "It's like a tree falling in an empty forest," Lema said. "If pain signals go to an unconscious brain, they're still capable of causing damage to the nerve endings."

    In the past, doctors were hesitant to give popular pain relievers known as NSAIDs (which include aspirin and acetaminophen) before surgery because they could cause excessive bleeding. But newer, safer Cox-2 pain medications don't carry that risk.

    A recent study found patients who were given Cox-2 drugs one hour before minimally invasive knee surgery had an additional six hours of pain relief after surgery and needed fewer pain medications in the days after surgery.

    Targeted Exercise Beats Surgery

    Some people with low-back pain may be able to avoid painful surgery altogether by following a targeted exercise plan that addresses their pain individually.

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