Back and neck pain relief – Opioids similar to placebo

By

-

July 7, 2023

Share on Pinterest

Design by MNT. Photography by CRISTINA PEDRAZZINI/SCIENCE PHOTOLIBRARY/Getty Images & Lock Stock/Getty Images.

Researchers compared the effectiveness of opioids versus a placebo in treating neck and low back pain.
After 6 weeks, there were no significant differences between the opioids and placebo groups. A year later, the placebo group scored slightly lower in terms of pain.
According to the findings, opioids may not be effective in treating certain types of pain.

Lower back pain is a common complaint.

Single leading cause

Disability worldwide. In 2020, there will be 619 millions people with disabilities in the world. By 2050, the number of people affected by this condition is expected to reach 843 millions.

Neck pain is a major contributor to disability in the world and is estimated as the

Fourth

Leading cause of disability measured in terms of “years of disability”

Clinical guidelines recommend opioids for people with neck or lower back pain when other treatments do not work. Studies show that opioids are a first-line therapy for many people with these conditions, including two thirds of those living in Australia.

Despite this, there is little to no evidence that the symbiotic relationship between humans and animals has been broken.

Evidence of the Usefulness of

There is evidence that suggests opioids are effective in managing lower back and neck pain. It is also known that opioids can increase the risk for a number of serious health problems.

adverse events

Such as opioid dependence, misuse and overdose.

Treatment options could be improved by further research on the effectiveness of opioids in treating neck and lower back pain.

Researchers from the University of Sydney in Australia have recently investigated the efficacy of short courses of opiates for treating lower back pain and cervical pain.

The study found that opioids were not superior to placebos in relieving pain and that opioid treatment increased the risk of abuse later on.

The study is published in

The Lancet

.

Medical News Today spoke to Charles De Mesa, a physician of osteopathic and chief of Interventional Pain, Physical Medicine & Rehabilitation at Hoag Spine & Specialty Clinic, California, who wasn’t involved in the study, regarding this research.

He told us:

“A high-quality research study shows that opioids do not work better than placebo for acute neck and lower back pain. There are too many risks, such as opioid abuse, and no benefit. Even short-term, judicious usage can lead to long-term harms such as intoxication, dependence, and overdose.

Researchers recruited 347 participants, with an average age 44,7 years. The participants were all women and had suffered from lower back pain or neck pain for 12 weeks or less.

The participants were randomly split into two groups in which they received guideline-recommended care and opioid oxycodone-naloxone or guideline-recommended care, and an identical placebo for up to 6 weeks.

Guideline-recommended care included reassurance and advice to stay active. Participants could seek additional care after 6 weeks if needed.

Researchers also assessed the intensity of pain in patients before and after treatment using the Brief Pain Inventory’s Pain Severity Subscale. This scale measures pain on a 0-10.

After 6 weeks, there was no significant difference between the opioid and placebo groups in terms of pain scores. The results were unchanged after adjusting for both the location of the pain and the number days since the pain began.

Researchers noted that the pain scores of the placebo and opioid groups did not differ much at all after 12 weeks, but that by 52 weeks, the placebo group had slightly reduced pain scores.

The average pain scores for the opioids group and placebo group at week six were 2,78 and 2,25 respectively. The pain score for the placebo group at 52 weeks was 1.81, while the opioid group’s was 2.37.

The researchers also found that there was no difference in the physical component of the quality of life between the two groups. The placebo group did experience a small but significant improvement in mental well-being at 6 and 12-weeks.

The opioid group was more susceptible to developing opioid abuse, even though there was no difference between the proportions of participants reporting adverse effects.

On the Current Opioid Misuse Measure Scale, after 52 weeks, 20% in the opioid group and 10% in the placebo group were classified as being “at risk”.

MNTasked for Dr. Wang Lushun, senior consultant orthopaedic surgeon at Arete Ortho, Singapore, who was not involved in the research, to explain why opioids might be ineffective in treating lower back and neck problems.

“Opioids, which are commonly used to relieve pain, may not be as effective in treating lower back and neck problems. Recent studies have shown this.” This is because opioids are primarily used to treat the perception of pain, and not the cause of the pain,” explained Dr. Wang.

By binding to opioid receptors, the drugs block the sensation of pain. “However, inflammation or physical injury — the common causes for these pains — is not actually alleviated,” explained he.

Over time, the body may also develop a tolerance to opioids. This can lead to the need for higher dosages to achieve the desired level of pain relief. This could lead side effects and possible dependency — one side effect is a phenomena known as opioid-induced Hyperalgesia which can result in even worse pain.

– Dr. Wang Lushun

Dr. Joel Frank, licensed psychologist at Duality Psychological Services, California, who was not involved in the research, responded to MNT when asked about the limitations of the study: “Firstly the treatment protocol was medication focused, but 42% were non-compliant. Second, their guideline care’ included recommendations for physical activity, but they claimed that the care was not monitored.

Dr Frank said, “Thirdly their primary measure of pain severity was the BPI. This is a self report measure.” Self-report measures by their very nature are subjective. It is important to include measures that evaluate pain categorization when using self-report pain measures. This will give a more complete picture of the subjective pain level.

MNT spoke with Dr. Vernon Williams who is a sports neurologist, pain management specialist and founding director of Cedars-Sinai Kerlan-Jobe Institute’s Center for Sports Neurology and Pain Medicine. He was not involved in the research.

Dr. Williams pointed out that the results were limited, as they did not compare opioid use with no treatment but rather compared it with a placebo which can induce a physical reaction.

“There are physiological effects related to your response to the expectation that the active treatment will be effective and your body’s reaction to the potential benefit – or expectation – of the placebo. The study did not show that the opioid was ineffective, but rather that it did not perform better than the placebo. He noted that it’s a subtle but significant difference.

MNT asked Dr. Gustavo De Carvalho Machado of the University of Sydney in Australia, who was not involved in the research, about the limitations of the study. He warned that:

The findings are not directly applicable in pre-hospital settings, such as those who require an ambulance or emergency departments. The results of this trial were not directly applicable to pre-hospital settings, where patients require an ambulance.

MNT and spoke with De Mesa regarding alternative treatments for lower back and neck discomfort.

“More effective alternative treatments for lower back and cervical pain address the underlying cause of pain. A physician can help determine the exact muscles and/or accompanying structures, such as tendons or ligaments, that are involved. He noted that physical therapy, ergonomic improvements and exercise could be prescribed.

“Spinal pain is often multifactorial, so a holistic approach to treatment can help an individual achieve long-term healing. Nutrition, acupuncture and cognitive behavioral programs, as well as physical conditioning, are also beneficial. As needed, anti-inflammatory over-the-counter medications can be used. The best treatment plan depends on the individual and their circumstances.

De Mesa said that spine surgeons, pain specialists and board-certified physiatrists could be recommended to treat chronic spinal pain.

“Chronic Pain may be caused either by arthritis in the spinal joints or by inflammation of the vertebral ends.” He explained that injections may be recommended to treat the source of the pain and pinpoint the pain generator.

“Radiofrequency ablation (destruction) of the spinal medial branches nerves and Basivertebral Nerve Ablation are two example of interventional procedures that may reduce pain and improve your quality of life. He noted that surgical options are only performed if medically necessary. They are usually reserved as a final resort.

Why was I having severe headaches and seizures? My Diagnosis Surprised Me

By

AmericanChiro

-

July 6, 2023

0

Around 20 years ago, I woke feeling sick one morning when I was in the second year of my teaching career. I was about to ask for a substitute when I felt dizzy. The next thing I know, I was lying on the floor. My husband told me that I had a seizure, and he called 911. My arms and legs moved, but I was unconscious the entire time. I was so terrified–I didn’t know anything had happened.

The doctors at the hospital examined me and told me I was fine. They sent me home because they thought I was sick (since I taught second graders, there was always a virus or flu going around).

It became a habit

Six months later it happened again, but this time I was alone at home. I felt dizzy, nauseous and then woke up in the middle of the floor. I called 911 and got to the hospital. They said, “Okay now we have a pattern.”

More from Prevention

I had not felt sick prior to this seizure so they knew that it was something else, but didn’t know what. I was referred by my doctor to a neurologist, and began getting tested for every possible condition. They checked to see if I had a heart problem, a brain tumour, diabetes or hypoglycemia. They even tested me to see if I had lupus. It was so discouraging. I kept hearing “Your test results were normal,” but I kept saying, “But this isn’t normal!” I was terrified as I had no control over my body and no answers.

Not just one, but two diagnoses

This continued for three years. My doctors were still trying to determine what was causing my seizures and which medicines would work best for me. I was always tired and felt like I wasn’t who I wanted to become. I was sent from specialist to specialists, and it felt like no one shared notes. My biggest fear was having a seizure right in front of students. Thankfully, this never happened.

I was then admitted to Barnes-Jewish Hospital, St. Louis. I stayed there for a full week, under observation. They tried to induce a seizure through adjusting my diet, preventing me from sleeping, and even flashing lights. The doctors confirmed I had epilepsy. A diagnosis changed my life. We could create a plan, and I could begin to live better.

The neurologist from Barnes-Jewish suggested that I see a headache specialist as I had terrible headaches ever since I was an teenager. I was diagnosed with migraine and now take two pills, one antiseizure medication and a monthly injection Aimovig to reduce migraine attacks. I’ve only had one seizure over the last 16 year period, which happened on a day when I forgot to take my medication. Some triggers, such as hormones and weather, I cannot control. However, I can control other factors, such as getting enough sleep and eating regularly. Migraine Road is a blog I started to help other migraine sufferers.

Lindsey De Los Santos

I’m now married to an amazing guy and we have two active sons. I teach fourth-grade, and my students have been wonderful. We discuss my health at the start of the school year and have a plan for what to do in the event of a seizure. They have big hearts. I spent years searching for the answers. I’m glad I didn’t give up because I wouldn’t have the life I have now.

What is epilepsy?

Around 3.4 million children and adults in the U.S. suffer from epilepsy. This chronic condition is diagnosed when a person experiences two or more unprovoked seizure. Seizures result from asynchronous brain activity, which manifests as involuntary movements or “spacing-out” or full-body convulsions.

Pooja Patel M.D. explains that seizures can be caused by many other things, such as alcohol, drugs, infection, or electrolyte balances. “But if someone has two seizures without a known cause, it may be diagnosed with epilepsy.”

In some cases, epilepsy is traced back to genetics or brain injuries, but in most cases, the cause is unknown. Stress does not cause epilepsy but it can lower the threshold of seizures in someone with epilepsy. Other triggers include lack of sleep and flashing lights. Researchers are still trying to find a link between migraine and epilepsy. However, many people with epilepsy — especially young women — also suffer from migraine.

Antiepileptic drugs are the first line of treatment, and they control seizures in seven out of ten patients. Other options include surgery, the ketogenic diet or implanted neurostimulation device.

Seizures symptoms

No difference was found between the pain severity of low back and neck pain when compared to placebo

By

AmericanChiro

-

July 6, 2023

0

July 5, 2023

Read for 1 minute

[email protected].

Takeaways from the conference:

Opioids do not reduce pain intensity for acute, non-specific neck or low back pain.
Researchers recommend that nonpharmacological treatments should be used to treat low back pain.

Results published in The Lancet revealed that opioids did not reduce pain in adults with low-back and neck pain compared to placebo.

Caitlin P. Jones, PhD faculty of health and medicine at The University of Sydney and colleagues wrote: “This finding calls on a change in the use of opioids frequently for these conditions.”

The data were obtained from Jones CMP et al. Lancet. 2023;doi:10.1016/S0140-6736(23)00404-X.

Jones and colleagues randomly assigned 347 adults with at least 12 weeks of low back pain, neck pain or both of at least moderate pain severity to receive guideline-recommended care plus either an opioid (n=174) or placebo (n=173) for up to 6 weeks. Researchers collected data at baseline, 2, 4, 6, 12, 26, 52 and 52 weeks. They also measured pain severity using the pain severity subscale from the Brief Pain Inventory.

In total, 89% of the patients were included in primary analysis. The results showed that there were no significant differences between the control and opioid groups in terms of mean pain scores after 6 weeks (2.78 vs. 2.25) Researchers found that the Roland-Morris Disability Questionnaire showed a significant difference for patients with low-back pain. This was in favor of the placebo group after 6 weeks. Researchers found that the placebo and opioid groups did not differ significantly in terms of quality of life when it came to the physical function subscale. However, they did find a small but significant difference on the mental health subscale between 6 and 12 week for the placebo group.

7.5% of patients who received opioids reported adverse events related to opioids, compared to 3.5% of those in the placebo-controlled groups.

“We report that there is a small, but significant risk of harm after a year’s use of [opioids], even if it was short-term.” This finding is contrary to guidelines that recommend opioids be used judiciously in acute back pain. We found that there were no benefits, but there was a risk of harm,” researchers wrote in their study. “Our findings support the changes to guideline recommendations for low-back pain management. These have seen a shift from pharmacological treatment to nonpharmacological therapies, such as psychological and physical therapies.”

Know the causes

By

AmericanChiro

-

July 5, 2023

0

Know the causes.

Quality of Japanese online information on causes of neck pain: A biopsychosocial analysis

By

AmericanChiro

-

July 5, 2023

0

Specialty

Rishi Sunak’s many headaches

By

AmericanChiro

-

July 4, 2023

0

Press play to hear this article

Artificial intelligence is able to speak.

Rosa Prince, I’ll also be with you on Tuesday.

DRIVING DAY

IT IS NOT EASY TO BE A PM:Rishi hasn’t been having the best of days with predictions that his by-election campaign would be wiped out, his NHS plan being overshadowed and Daniel Korski self-defenestration, plus last week’s Rwanda Scheme court blow. Today, a group red wall Tory members publishes a “alternative” manifesto to cut immigration. The Sun describes this as a “fresh attack on the prime minister’s authority.”

With Friends Like These:Most papers agree that the plan drafted by the New Conservatives Group of Tory MPs re-elected in 2017 and 2019 poses a direct threat to the PM. The group wants the government to fulfill its manifesto promise to reduce net migration to below 226,000 before the next election to “save faces” and maintain voter trust. Party Vice Chairman Lee Anderson, among other MPs, has backed their 12-point plan.

The planProposals are to increase salary thresholds for immigrant workers, limit visas for care workers, stop foreign students from staying after they graduate, and tighten language requirements. Tom Hunt, Ipswich’s MP, was one of the authors of the plan. He explained its motivation on BBC Radio 4’s Westminster Hour: “When I knock at doors and talk to constituents about immigration, it is a major issue that keeps coming up.”

Suella boost The Times reports that the demands have the effect of bolstering the Home Secretary Suella in her internal arguments against Chancellor Jeremy Hunt, and Education Secretary Gillian Keegan. They are concerned that restricting immigration would harm the economy and lucrative university sector.

**A Message from Google:Google wants to help the UK economy grow. To do this, we need businesses and individuals with the right digital skills. Since 2015, we have provided free training to more than 1 million people. Find out more about our free training in digital skills here. **

Baker and Braverman Less fortunately for the home secretary, the Mail and Guardian were both informed that former supporter Steve Baker turned against Braverman after her suggestion that there was a “predominance of British-Pakistani males involved with sexually abuse grooming gangs. Baker’s Wycombe Constituency has a large proportion of Asian voters and he will defend just over 4,000 votes at the next elections.

(No,) stopping the boat:The New Conservative Group’s manifesto is not good news for Sunak. It shows how he is struggling to fulfill his promise to “stop” the boats, which was one of five pledges that he made to himself six months ago.

5 alive The Times gives a damning evaluation of Sunak’s progress in achieving his five pledges. The Times scores Sunak from 1 out 5 for reducing national debt, to a not so impressive 3 out 5 for the prospects of growing the economy.

ICYMI If he had not received enough helpful advice by the weekend, it was reported that Liz Truss, former PM of Australia will be launching her new “Growth Commission”, later this month. The group, led by economist Douglas McWilliams will examine the causes of slow growth and analyze the impact of government policy on GDP.

POLLTASTICMore bad results for Sunak from a series of polls released overnight. Two-thirds of respondents to a BMG survey for the i blamed the government for high prices. The paper reported the results. The same poll found that 45 percent of respondents now believe Britain should join the EU. This compares to 40 percent who would like to remain out and 14 percent are unsure.

Polls, Part 2:A separate poll conducted by Ipsos on behalf of the Health Foundation found that two-thirds (67%) of voters believed the NHS would abandon the principle of providing free care at the time of delivery. That’s what the Guardian splashed.

On this note: Aneira, the retired nurse and first baby born in the NHS, gave an interview to The Mirror to mark its 75th anniversary. She accused the government of taking health care back to “dark times.”

Polls, Part 3:The Mail reports on a poll that shows only one out of four voters support the campaign to delay 2030’s ban on petrol and Diesel car sales. Kemi Badenoch, the UK’s Trade Secretary, is said to be concerned that the deadline may affect car manufacturing in the U.K.

Read this: Badenoch is increasing pressure on the EU in order to protect electric vehicle manufacturers from being affected by new Brexit trade regulations in 2024. My POLITICO colleagues Graham Lanktree, and Stefan Boscia have reported.

The economy must be in bad shape:Nick Timothy declared that capitalism isn’t working.

We’re here to help:Altruism is still alive and well. The Times has an article on the Patriotic Millionaires – a group of Richie Riches that calls for the wealthy pay more taxes.

ANOTHER TORY HEADACHE: There is a lot of unhappiness on the Tory back benches — and even some on the front benches — about the anti-BDS bill (Boycott, Divestment, Sanctions), Playbook’s Eleni Courea hears before its second reading tonight. Around 10 Tory members met with Chief Whip Simon Hart to express their concerns last week (but the real number of rebels “is much more than that,” said one MP).

The purpose of the bill…was that it would ban local councils from a boycotting Israel – fulfilling a manifesto promise. This was not a surprise to anyone, but it was a hot political topic and difficult to codify. Eleni has spoken with multiple Tory MPs, who are concerned about the bill’s single-out of Israel, its potential to stifle criticism or action against other countries, including China, as well as the threat it poses to freedom of expression. Alicia Kearns, chair of the Foreign Affairs Committee, is expected to speak during the debate.

Trouble on both sides:The FT says that John McDonnell, the Shadow Chancellor, will vote against the Bill. The paper also reports that Labour MPs were ordered to abstain.

On a different note: Former Chancellor Sajid Javid wrote an op-ed for the Telegraph in support of the bill. The bill is being led by Michael Gove, Leveling Up Secretary and local government official. Javid says that the legislation will prevent local councils from “‘freelancing,’ in foreign policies.”

BIDEN IS IN TOWN

HAIL THE CHIEFSomething for the PM to cheer up: U.S. president Joe Biden is stopping by London next week on his way to Vilnius, where the NATO summit will take place. The White House announced this. In a visit to “strengthen our close relationship with our nations”, Press Secretary Karinejean-Pierre stated in a press release. He will call on Rishi Sunak as well as King Charles. Hugo Gyre of the i got the scoop two weeks ago.

WINDSOR AGREEEMENT Buckingham Palace confirmed Biden’s meeting with the king on the evening of 10 July at Windsor Castle. The PM will be eager to see the president after a warm relationship that has developed in recent months.

You are very welcome:A number A spokesperson for 10 said last night that the prime minister is looking forward to welcoming U.S. president Biden to the U.K. in the latter part of this month. This shows the strong relationship between U.K. & U.S. It builds on a series bilateral visits & meetings earlier this year.

CLEVERLY IS IN EUROPE: Speaking of NATO, Foreign Minister James Cleverly will be in Brussels today where he’ll make his first speech before the EU Parliament and co-chair with European Commission Vice President Maros SEFCIOC the 11th Joint Committee Meeting on the Withdrawal Agreement. Cleverly will outline the U.K. priorities for cooperation on trade and Ukraine before meeting European Parliament president Roberta Metsola, and NATO Secretary General Jens Stoltenberg. They will discuss how to support Ukraine and how the NATO alliance can adapt to new threats, including increasing defense spending. Cleverly will emphasize the U.K.’s support for Sweden becoming a NATO member.

So mature Speaking ahead of the visit Cleverly said: “This marks a new chapter in U.K.-EU relations. We stand united in our support for Ukraine, and want to maximize the benefits of our trade agreement. We don’t need to agree on every issue. A mature relationship can handle differences.

EDUCATION

BRIDGET’S BIG DAY It’s a mega-day for Shadow Education Secretary Bridget Phillipson. She has just finished her Sunday broadcast and is now promoting her plans to send “super teachers” to struggling schools in underprivileged communities. She also has an article in the Sun, promising to produce “the next generation” of brickies with construction apprenticeships. She will also be on James O’Brien’s LBC program at 12.30 pm. She’ll also help Labour leader Keir starmer launch his “mission” to increase opportunities later in the week. Phew.

Show a little respect.Labour today will also pledge to reestablish the teaching profession as a respected one, with more money for new recruits and a higher status, to address the lack of talent entering the profession. Phillipson, in pre-briefed remarks, said: “Only Labour can re-establish the teaching profession as one that is respected and valued for its skill as a job that delivers for our nation.”

Private pledgePhillipson’s promise to reward teachers who complete two years of teaching with a PS2,400 bonus as a way to improve retention would be funded through the ending of tax breaks for private school. Phillipson said on Times Radio that the cost would be just over PS56million and that it would come from ending tax breaks for private schools.

Teachable Moment:Phillipson has also released figures showing that state schools have spent PS8 Billion recruiting replacement teachers since 2010

Sorcerer’s Apprentice:The Sun’s story states that the number of apprenticeships completed has dropped by 40% in the last five years. Keir Starmer’s latest “mission” address will be announcing his plans for education later this week. It will focus on how to overcome barriers.

Reminder The latest NEU strikes will be coming down the track on Wednesday and Friday like a locomotive, heading straight towards parents. Jonathan Gullis, Minister of School Standards, said: “The Conservative Government wants to put students and parents first. The NEU should do the sam.

RISE UPS: Meanwhile, former Labour Education Minister David Blunkett told the House’s Tali Frasier that he would “far less tolerant” than the current students regarding the marking strike which has ruined their graduation prospects. Their university experience had already been a mess thanks to COVID.

Cover star The latest edition of House also features an interview with Gillian Keegan whose comments on the government’s much-anticipated guidance for schools regarding trans issues were picked by the Telegraph at the weekend. She and Schools Minister Nick Gibb will meet Tory MPs at 5 p.m. to discuss the plans, amid anger among the backbenches over the “limbo”, schools have been in due to delays with the guidance.

MORE LABOUR LAND

OOH la Lammy: Shadow Foreign Secretary David Lammy will be in Paris today for talks with French Minister of Foreign Affairs Catherine Colonna on the Quai D’Orsay. He will then meet with Transport Minister Clement Beaune. They will discuss Labour’s plans to “rebuild U.K. – France ties, as well as the proposed U.K. – EU security pact.”

Talks in the tank:Lammy is also visiting the think tank Institut Montaigne while he is in Paris. While in Paris, he will present proposals for a new agreement on safe return and family reunion and pledge to crackdown on smugglers gangs. According to a press release issued before the trip, Lammy plans to say that he wants “to make Brexit work for the British public by fixing the gaps in the Tories botched Brexit deal during the scheduled Trade and Cooperation Agreement Review 2025.”

POUNDSHOP BLAIRITESKeir’s purge of the Left and last week’s disciplinary actions against Compass chief Neil Lawson because he tweeted about electoral pacts show that the Labour leadership wants to replace lefties by “pound-shop Blairites,” Poppy Wood reports for the i.

They came for me next:On a similar theme, John McDonnell, the former Shadow Chancellor told the FT that the leadership was looking for an excuse for him to be suspended. Gotta love “Starmer’s ally’s” response to the notion that the trigger could be tonight’s Israel boycott bill. “That’s not something anyone wants to fight.”

ASIAN ASLANSThe Twitter spat between superhead Katharine Burbalsingh, and Labour frontbencher Jess Phillips makes Playbook’s brain hurt. Luckily, the Guardian’s Rowena Mason had the stamina it took to write about it.

MIDDLE AGE MAYHEM: Women aged 45-65 could be the key to Labour and Lib Dems’ fortunes in the general election, according to the Times. For those who enjoy archetypes, this report adds the words “Surrey Shufflers,” a “Take a Breaker,” “WI” and “National Trusters.”

Today in Westminster

SEEING YOU AGAIN IN COURT: The second day of the Cabinet Office vs. COVID inquiry High Court Case over the release of Boris Johnson’s unredacted WhatsApps During the Pandemic begins in court 3 at 10.30 am.

SHADES of GRAY: The results of the government’s investigation into Partygate Inquisitor Sue Gray’s contacts with Labour, will be presented to parliament today in the form a WMS. Labour’s response is essentially: “whatever”, the Mail reports.

BROKEN BRITAIN The BMA Annual Conference starts today in Liverpool. According to the Mirror, doctors are threatening a strike until the next general election unless an improved pay deal is reached. The union’s senior doctor, Phil Banfield will call for urgent negotiations, claiming that there is a lack of trust between doctors and the government.

Pay Up:The Times splashes a hint by Health Secretary Steve Barclay, that more money could be found if also the union moved away from its 35 percent demand. The Times reported that Barclay is in favor of adopting the recommendations from the independent Review Body on Doctors’ and Dentists’ Remuneration. This body is expected to recommend a 6 percent increase.

The robot is now watching you: Meanwhile, Barclay also ordered NHS trusts that they use the new funding (somewhat mysteriously obtained) for extra staff in order to recruit more doctors, nurses, and not bureaucrats.

NO TRUTH: According to a report published by the Times, half of women who witnessed or experienced a crime within the last year did not report the incident because they didn’t believe that the police would take their claims seriously.

THE KID IS OK:Young adults living in areas of high anti-social behaviour in England will be able to access more sports, arts, and other opportunities this summer thanks to funding from the Million Hours Fund.

PHONES:Former Tory Leader Iain Duncan Smith warned that the merger between Vodafone & Three was “dangerous,” as it could give a Chinese-based company a prominent position in the U.K. mobile network. Duncan Smith told The Independent: “This dangerous deal is another example of the Communist Party’s attempt to create a Western dependence on China.”

DON’T BANK IT:The Telegraph reports on the Treasury telling banks they must protect freedom speech following a growing outcry over customers with controversial views being blacklisted. Chancellor Jeremy Hunt, it is believed, is “deeply worried” about lenders closing down accounts because they disagreed with the opinions of customers. He has asked Andrew Griffith, City Minister, to investigate.

FUELING the FLAMES:The Government plans to crackdown against service station profiteering, by telling motorists through a comparison site where they can purchase the cheapest gasoline. The Telegraph has an article.

FACING MUSIC:Evidence Week begins in parliament. The event, which was created in 2018 to respond to the public’s growing interest in policy evidence and will be livestreamed starting at 5 pm, allows constituents to ask their MPs questions about policy decisions.

SW1 ACTIVITIES:Former Minister of Finance Sajid Javid talks about his time at the Institute for Government with Director Hannah White starting at 9.45 am.

HOUSE of COMMONSSits at 2.30 pm with Home Office Questions… and then, the main business of the day is the second reading of Economic Activity of Public Bodies Bill (Overseas Matters). Labour’s Ruth Cadbury leads the adjournment discussion on crime and antisocial behavior in West London.

WESTMINSTER HAL: Debate from 4.30 pm an e-petition regarding the Approved mileage Allowance Payment Rate (led by Tory MEP Elliot Colburn).

On the committee corridor:Directors of Public Prosecutions Max Hill give evidence to the Justice Committee at 2.30 p.m…. NHS England’s Chief Executive Amanda Pritchard and DHSC’s Permanent Secretary Chris Wormald speak to the Public Accounts Committee regarding access to emergency and urgent care at 4 p.m…. and Electoral Commission representatives are questioned about electoral registration by the Leveling

HOUSE of LORDS: Sits at 2.30 pm with oral questions about the Drax biomass power plant, the U.K. production of nuclear subs under the AUKUS Agreement and recommendations on cybersecurity… and then main business is the Illegal Immigration Bill on the second day.

BEYOND M25

PILE ON PYLONSEnvironment secretary Therese Coffey has launched a campaign against the section of a pylon line that will cross her Suffolk Coastal Constituency. Kemi Badenoch who represents Saffron Walden, Essex, also called for a reconsideration. The Telegraph published a piece on the subject. It follows the Sunday Telegraph splash that said hundreds of miles of pylons would be accelerated so the U.K. could meet its net-zero goals.

YET A NEW MAYOR:Tory MEP Ben Bradley announced that he was running to become the first mayor of East Midlands. He called for the region to have the power to reduce taxes. Bradley pledged in a Telegraph article that he would not introduce ULEZ policies, as seen in London and other cities.

ORKNEY GOES NORDIC: Orkney Council will discuss “alternative governance forms” with their Nordic neighbor. James Stockan, the authority leader, believes Orkney is not treated fairly in terms of funding and policy support. Orkney could do better under the Norwegians. STV News has this story.

VICTORIA REMEMBERS:Ukrainian war crimes researcher and writer Victoria Amelina, 37, died after being injured in Kramatorsk by a Russian missile. Journalist Olga Tokariuk stated that Amelina left “so many unwritten books, stories untold and days unlived.”

TRADE AWAYTrade minister Nigel Huddleston is on a three-day trip to Kolkata, India, and Dhaka Bangladesh to announce initiatives to help U.K. companies sell to both countries.

RIOTS IN FRANCE SHOW SIGNALS OF DEESCALATION After six nights of looting, violence and clashes the French authorities seem to be deescalating the riots which broke out in France after a policeman killed Nahel a 17-year old of North African descent during a traffic check in Paris last Thursday.

Over this weekend: On Sunday night, tens of thousands more police were sent on patrol to try to prevent further rioting. On Saturday, President Emmanuel Macron rescheduled a trip to Germany in order to deal with the crisis at home. John Lichfield writes in a commentary for POLITICO that the riots have created a “spiral” of suspicion, misunderstandings, rejections and fear.

**A Message from Google:Since the year 2015, Google has offered free digital skills training in more than 500 locations across the UK. From Manchester to Port Talbot to Sunderland, Bristol to Bristol, Google ensures that small businesses and individuals are equipped with the skills needed to grow. Find out more about our free training in digital skills here. **

MEDIA RUND

Culture Minister Lucy Frazer broadcast round :Sky News (7:30 a.m.),… LBC (7:30 a.m.),… GMB (8.30 am.).

Shadow Schools minister Stephen Morgan broadcast round :GB News (7.20 a.m.), Times Radio (7.45 a.m.), Sky News (8.05 a.m.), LBC News (8.40 a.m.).

Also, on GB News Breakfast :Former Tory advisor Claire Pearsall (6.30 a.m.; 7.30 a.m.; and 8.30 a.m.).

Also heard on Times Radio: Former Victims’ Commission Vera Baird (7.35 am)… Ineos Chairman and Founder Jim Ratcliffe (8:00 am)… Susan Hall a shortlisted Tory candidate for London mayoral election (8.35 am).

Also on Sky News Breakfast : ASLEF general secretary Mick Whelan (7.20 am)… Rwandan leader of opposition Victoire Umuhoza (7.35)… BMA junior doctors committee member Arjun Sing 8.30 am

Also, on Nick Ferrari’s Breakfast: Former Met Police Commander Roy Ramm (7.05 a.m.)… Former Met Police Superintendent Nusrit mehtab (8.35 am.).

TalkTV breakfast:Former Tory health secretary Stephen Dorrell (7.05 am)… crossbench peer Norman Warner 8.05.

Politics Live (BBC Two, 9.45 a.m. ): Tory MP Bim O’Grady… Labour peer Frances O’Grady… Alex Phillips of Reform U.K…. Observer’s columnist Sonia Sodha.

James O’Brien Shadow Education Secretary (LBC). Bridget Phillipson Phone-in (12.30 to 1.00 pm).

TODAY’S FRONT PAGES

POLITICO UK Brexit cliff edge has electric carmakers spooked, as talks falter.

Daily Express Doctors raise the specter of NHS strikes up to 2025.

Daily Mail Stop the “damaging” 2030 petrol vehicle ban

Daily Mirror “Super Teacher” hit squads for Schools

Daily Star China’s lunar nukes

Financial Times Bond fund titan Pimco prepares to “harder land” in the global economy

i : Voters blame Sunak for “poor” handling inflation.

Metro : Just Not Cricket!

The Daily Telegraph Banks should respect the right to free speech of their customers

The Guardian Fears that NHS will have to charge for services are growing.

The Independent – Shameful

The Sun : Out of… order.

The TimesDoctors will get a pay promise if they end their strike.

LONDON CALLING

WESTMINSTER METEOROLOGY: Light Rain with a Moderate Blow. Highs of 19C.

IN MEMORY: Former civil service head Bob Kerslake died of cancer at the age of 68, according to his sister Ros Kerslake Labour leader Keir starmer said Kerslake is a “talented professional, and good man”. His daughter Eleanorsaid Kerslake has had many jobs, but the most important thing to him was that he was a fantastic husband, father, brother, son, and granddad.

NEW GIG Donjeta Miftari is now a political advisor to Labour’s National Coordinator Shabana Mahamood. She was previously the chief communications adviser for Kosovo’s president Vjosa Omsmani.

Kate McCann Congratulations to Kate McCann, who will be the political editor of Times Radio from September. She was previously the political editor of TalkTV.

STRAWBERRIES & CREAM PLEASE! Wimbledon coverage starts on BBC Two at 10.30 am, bringing Politics Live forward.

LISTEN: Kirsty Warsk discusses NHS at 75, with guests including The Spectator’s Isabel Hardman GP Phil Whitaker on Radio 4’s “Start the Week” at 9 a.m.

ROLL THE BARREL : Journalist Nadine White’s first film about the Windrush Generation, titled “Barrel Children,” plays now in select Picturehouse cinemas. Dates are listed here.

NOAH’S CULTURE FX:Comedian Matt Forde interviewing fellow comic Joe Lycett at the Duchess Theatre, 7.30 pm. Tickets are available here.

READ NOW: The New Statesman interviews Facebook Whistleblower Frances Haugen who expresses concerns about the impact Big Tech will have on the U.S. elections in 2024.

BIRTHDAYS – Former Ealing North M.P. Stephen Pound… Scottish Labour MSP Katy Clark… Maitland Jay Turner… WikiLeaks founder Julian Assange.

Playbook wouldn’t have been possible without my editors Jack Lahart, Zoya Sheftalovich and Noah Keate. Producer Dato Parulava and reporter Noah Keate also contributed.

London Playbook Global Insider

Rosa Prince: More from the… Rosa Prince

Tonix Pharmaceuticals Completes the Acquisition of Two FDA Approved and Marketed Migraine Product

By

AmericanChiro

-

July 3, 2023

0

Tonix Pharmaceuticals Holding Corp.

Strategic acquisition helps Tonix build its commercial capabilities and infrastructure ahead of potential launch of TNX 102 SL to manage Fibromyalgia

Tonix’s current intranasal clinical development program of TNX-1900, for migraine prevention, is complemented by the acquisition of Zembrace (r) SymTouch (r) and Tosymra (r) (sumatriptan spray).

CHATHAM, N.J., JULY 03, 2023 — Tonix Pharmaceuticals Holding Corp., a biopharmaceutical firm, and its wholly-owned subsidiary Tonix Medicines, Inc., (Tonix Medicines), announced today that they have completed the acquisition of the two currently-marketed products by Upsher-Smith Laboratories, LLC. Zembrace SymTouch (sumatriptan injectable) 3 mg, and Tosymra (sumatriptan) (ups) (Ups) (Ups) (Ups) (Ups) (Ups) (Ups) (Ups) (Ups As previously announced, the combined product sales for these products were approximately $23 millions in 2022.

Seth Lederman M.D. is the Chief Executive Officer at Tonix Pharmaceuticals. He said that the acquisition of these products represents a significant step in Tonix’s evolution into a fully-integrated biopharmaceutical firm and builds on Tonix’s expertise in central nervous system disorders. “In addition to the growth potential that these two products represent over time the acquisition helps Tonix build its commercial capabilities ahead of the possible launch of our TNX 102 SL product for the treatment fibromyalgia and aligns strongly Tonix’s TNX-1900 product candidate (intranasal-potentiated oxytocin), which is in clinical development.

“Migraine and breakthrough headaches are still a significant burden. We believe that both Zembrace SymTouch, and Tosymra, can be used to meet the unmet needs of those patients who use oral acute migraine medications currently, or have recently developed, especially for rapid-onset treatment,” stated James Hunter, Executive vice president of commercial operations at Tonix Pharmaceuticals, and President of Tonix Medicines.

It is the only sumatriptan-autoinjector brand actively promoted in the United States. Other sumatriptan-autoinjectors on the market include Imitrex (r) and generics of Imitrex (r). It is a low-dose product that has shown migraine pain relief as early as 10 minutes (17% of patients vs. only 5% of placebo patients). ² Zembrace SymTouch has also demonstrated migraine freedom for 46% (vs. 27% for the placebo group) at 2 hour in a double-blind, single-attack study (N=230). ³ Zembrace SymTouch has patent protection until 2036. Tosymra uses Intravail(r), a permeation enhancer, and is pharmacokinetically equal to 4 mg of subcutaneous sumatriptan.

About Migraine

Nearly 40,000,000 Americans suffer from migraine ⁷. It is the second leading cause for disability in the United States.

References:

IQVIA 2022 estimates Zembrace and Tosymra retail sales at $19.6M and $3.5M respectively.
Mathew NT, et al. Subcutaneous sumatriptan is effective and safe in doses ranging from 1 to 10 mg. US Sumatriptan Research Group. Arch Neurol. 1992;49(12):1271-1276.
Landy, S. et al. Efficacy of DFN-11 (3 mg sumatriptan) in adults with episodic headache: a multicenter, double-blind placebo-controlled, randomized study. J Headache Pain. 19, 69 (2018).
Brand-Schieber E, Munjal S, Kumar R, et al. Human factors validation of 3 mg sumatriptan injector for migraine patients. Med Devices (Auckl). 2016;9:131-137.
Tosymra [package leaflet]. Maple Grove, MN, Upsher-Smith Laboratories, LLC, Feb 2021.
Wendt J, et al. A randomized, controlled, double-blind trial evaluating the efficacy and safety of a subcutaneous dose of sumatriptan of 4 mg for the treatment acute migraine attacks among adults. Clinical Therapeutics. 2006;28(4):517-526.
GBD 2016 Headache Collaborators. Global, regional, national, and local burden of migraine and tension type headache, 1990-2016 : a systematic study for the Global Burden of Disease Study 2016 Lancet Neurol 2018;17(11):954-976.
Headache Classification Committee (IHS) The International classification of headache disorders in its 3rd edition. Cephalalgia. 2018;38(1):1-211.

Tonix Pharmaceuticals Holding Corp.^*

Tonix is a biopharmaceutical firm that focuses on commercializing, developing and discovering therapeutics to treat, prevent and alleviate human disease. Tonix sells Zembrace(r), SymTouch (r) (sumatriptan injectable) 3 mg, and Tosymra (r) (sumatriptan spray) 10mg. Both are indicated for acute migraines with or without aura. Tonix’s product portfolio consists of candidates for the central nervous system, rare diseases, immunology and infections. Tonix’s CNS portfolio includes small molecules and biologics for treating pain, neurologic and psychiatric conditions, as well as addiction. Tonix’s leading CNS candidate (TNX-102 SL, cyclobenzaprine HCl Sublingual Tablet) is in Phase 3 development for the treatment of fibromyalgia. Topline data are expected in the first quarter 2024. TNX 102 SL is being developed for the treatment of Long COVID (a chronic post-acute COVID-19). The Phase 2 study enrollment is complete, and topline findings are expected to be available in the third quarter 2023. TNX-601 (tianeptine extended-release tablets), an oral once-daily formulation that is being developed to treat major depressive disorder, is also enrolling. Topline results are expected in the first half of 2024. TNX-4300 is a small molecule orally administered therapeutic that is in preclinical testing to treat MDD, Alzheimer’s disease and Parkinson’s disease. TNX-1900, intranasal-potentiated oxytocin, in development for chronic headaches, is currently enrolling. Topline data are expected in the fourthquarter of 2023. TNX-1300, a biologic that treats cocaine intoxication, has been designated as a Breakthrough Therapy by the FDA. A Phase 2 study for TNX-1300 should begin in the third quarter 2023. Tonix’s portfolio of rare disease development includes TNX-2900, an intranasal potentiated oxytocin for the treatment Prader-Willi Syndrome. TNX-2900 was granted Orphan Drug status by the FDA. Tonix’s Immunology Development Portfolio includes biologics that address organ transplantation rejection, autoimmunity, and cancer. TNX-1500 is a humanized, monoclonal, antibody targeting CD40L (CD154), which is being developed to prevent allograft reject and treat autoimmune diseases. A Phase 1 study for TNX-1500 should begin in the third quarter 2023. Tonix’s pipeline of infectious diseases includes TNX-801 – a vaccine being developed to prevent smallpox or mpox. TNX-801 can also be used as a platform for recombinant pox or live virus vaccines to treat other infectious diseases. The portfolio of infectious disease development also includes TNX-3900, TNX-4000 and classes of broad spectrum small molecule antivirals.

* Tonix’s product development candidates are investigational drugs or biologics that have not been approved by the FDA for any indication.

Tonix Medicines is the registered trademark owner of Zembrace SymTouch, Tosymra and Tosymra. Intravail, a registered trademark, is owned by Aegis Therapeutics, LLC, which is a wholly-owned subsidiary of Neurelis, Inc.

You can find this press release as well as additional information about Tonix at www.tonixpharma.com.

Forward-Looking Statements

Certain statements in this release are forward-looking, as defined by the Private Securities Litigation Reform Act of 1996. These statements can be identified by forward-looking words like “anticipate”, “believe”, “forecast”, “estimate”, “expect”, and “intend”. These forward-looking statement are based on Tonix’s current expectations, and actual results may differ materially. There are several factors that could cause the actual events to differ significantly from those stated in such forward-looking statement. These factors include but are not restricted to risks related the failure to obtain FDA approvals or clearances and non-compliance with FDA regulation; risks related the failure of our products to be successfully marketed; risks relating to the timing and the progress of clinical development for our product candidates; risks relating to our need for additional funding; uncertainties regarding patent protection and litigation, uncertainties regarding government or third party payer reimbursement; limited research efforts and dependence on third parties; and significant competition. As with any pharmaceutical product in development, there are risks associated with the development, approval by regulatory agencies, and commercialization of a new product. Tonix is not obligated to update or revise forward-looking statements. Investors are advised to read the risk factors in the Annual Report on the Form 10-K for year ending December 31, 2022 as filed with Securities and Exchange Commission (“SEC”) March 13, 2023 and periodic reports filed at or after that date. All forward-looking statements by Tonix are expressly qualified with all of these risk factors and cautionary statements. The information contained herein is only current as of the date it was published.

Investor Contact

Jessica Morris

Tonix Pharmaceuticals

[email protected]

(862) 904-8182

Peter Vozzo

ICR Westwicke

[email protected]

(443) 213-0505

Media Contact

Ben Shannon

ICR Westwicke

[email protected]

(919) 360-3039

Zembrace(r) SymTouch(r) (sumatriptan Injection): IMPORTANT SAFETY INFORMATION

Zembrace SymTouch can cause serious side-effects, including heart attacks and other heart problems that may lead to death. If you experience any symptoms of a heart attacks, stop using the product and seek emergency medical attention.

Discomfort in the middle of your chest that lasts more than a few moments or comes and goes
Severe tightness, pain, or pressure in your chest, neck, jaw, or throat
You may experience pain in your arms, back or neck, jaw, or stomach
Shortness of breath without chest discomfort
Breaking out in cold sweat
nausea or vomiting
Feeling lightheaded

Zembrace should not be used by people with heart disease risk factors (high blood pressure, high cholesterol, smoking or being overweight, diabetes, a family history of heart problems, etc.) unless an examination of the heart shows that there is no problem.

Zembrace should not be used if you:

Heart problems in the past
Narrowing of blood vessels in your legs, arms or stomach (peripheral arterial disease)
Uncontrolled high blood pressure
Hemiplegic migraines or basilar headaches. Ask your provider if you are unsure if you suffer from these migraines.
Have you had a stroke or TIA?
severe liver problems
Taken any of the following medications in the past 24 hours: ergotamines (dihydroergotamine), eletriptan.

If you are taking monoamine oxidase-A (MAO-A) inhibitors, or if it has been less than 2 weeks since you stopped taking MAO-A inhibiters. If you are unsure, ask your doctor for a list.
Zembrace is not recommended for people who have an allergy to sumatriptan, or any of its components.

Tell your provider all your medical conditions, medications and vitamins and supplements you take.

Zembrace may cause dizziness or weakness. If you feel drowsy, do not drive, operate machinery, or perform any other activity that requires alertness.

Zembrace can cause serious side effects, including:

Changes in color or sensation of your fingers and toes
Weight loss, nausea, vomiting, constipation, diarrhea, or bloody diarrhea
If you experience any of the following symptoms, please consult your doctor.
Increased blood pressure, including a sudden and severe increase even if there is no history of high pressure
Medication overuse headaches are caused by taking migraine medication for more than 10 days per month. If your headaches get worse, call your provider.
Serotonin Syndrome is a rare, but serious, problem that can occur in people who use Zembrace. This is especially true when combined with antidepressant drugs called SSRIs and SNRIs. Call your doctor immediately if you experience mental changes, such as seeing things not there (hallucinations), agitation or coma, a fast heartbeat, changes in blood pressure or high body temperature.
Hives (itchy bumps); swelling in your mouth, throat, or tongue
Even people who have never experienced seizures can experience seizures

The most commonly reported side effects of Zembrace are: Pain and redness around the injection site, tingling in your fingers or toes, dizziness, a warm, hot or burning sensation on your face (flushing), discomfort or stiffness in the neck, feeling weak, drowsy or tired.

Inform your provider if any side effects bother you or do not go away. These are not the only possible side effects that can occur with Zembrace. Ask your provider for more information.

The information below is important but not exhaustive. Talk to your doctor and read the Patient Information & Instructions for use. You can also call 1-888 650-3789 or visit www.upshersmith.com.

Reporting adverse effects of prescription medications to the FDA is encouraged. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

INDICATIONS AND USAGE

Zembrace, a prescription medication, is used to treat migraine headaches in adults with or without aura.

Zembrace does not prevent migraines. It is unknown if Zembrace is safe and effective for children under the age of 18.

Tosymra(r) (sumatriptan nasal spray): IMPORTANT SAFETY INFORMATION

Tosymra may cause serious side effects including heart attacks and other heart problems that can lead to death. If you experience any signs of a heart attack, stop taking Tosymra immediately and seek emergency medical attention.

Discomfort in the middle of your chest that lasts more than a few moments or comes and goes
Severe tightness, pain, or pressure in your chest, neck, jaw, or throat
You may experience pain in your arms, neck, jaw or stomach.
Shortness of breath without chest discomfort
Breaking out in cold sweat
nausea or vomiting
Feeling lightheaded

Tosymra should not be used by people with heart disease risk factors (high blood pressure, high cholesterol, smoking, obesity, diabetes, family history, etc.) unless an exam of the heart shows that there is no problem.

Use Tosymra only if you do not have:

Heart problems in the past
Narrowing of blood vessels in your legs, arms or stomach (peripheral arterial disease)
Uncontrolled high blood pressure
severe liver problems
Hemiplegic migraines or basilar headaches. Ask your healthcare provider if you are unsure if you suffer from these migraines.
Have you had a stroke or TIA?
If you have taken any of these medicines within the last 24 hours, please let your provider know. If you are unsure if your medication is listed, ask your provider.
If you are taking monoamine oxidase-A (MAO-A) inhibitors, or if it has been less than 2 weeks since you stopped taking MAO-A inhibiters. If you are unsure, ask your doctor for a list.
Tosymra or any of its ingredients can cause an allergic reaction to sumatriptan

Tell your provider all your medical conditions, medications and vitamins and supplements you take.

Tosymra can cause dizziness, weakness, or drowsiness. If you feel this way, avoid driving a car or using machinery.

Tosymra can cause serious side effects, including:

Changes in color or sensation of your fingers and toes
Weight loss, nausea, vomiting, constipation, diarrhea, or bloody diarrhea
If you experience pain or cramping in your legs and hips, you may also experience a feeling of heaviness in the muscles. You may also experience burning or aching in your toes or feet while at rest, or numbness.
Increased blood pressure, including a sudden and severe increase, even if there is no history of high pressure
Overuse headaches are caused by taking migraine medication for more than 10 days per month. If your headaches get worse, call your provider.
Serotonin Syndrome is a rare, but serious, problem that can occur in people who use Tosymra. This occurs more often when combined with antidepressant drugs called SSRIs and SNRIs. Contact your doctor immediately if you experience any of the following: mental changes, such as seeing things not there (hallucinations), agitation or coma.
Hives (itchy bumps); swelling in your mouth, throat, or tongue
Even people who have never experienced seizures can experience seizures

Tosymra’s most common side effects include: tingling or dizziness; feeling hot or warm; feeling of heaviness and pressure. Other symptoms include flushing, tightness, numbness.

Inform your provider if any side effects bother you or do not go away. Tosymra can cause other side effects. Ask your provider for more information.

Tosymra is not covered in this list. Talk to your doctor and read the Patient Information & Instructions for use. You can also call 1-888-650-378 or visit www.upshersmith.com.

Reporting side effects of prescription medications to the FDA is encouraged. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

INDICATIONS AND USAGE

Tosymra, a prescription medication, is used to treat adults with acute migraine headaches that may or may not have an aura.

Tosymra cannot be used to treat other types headaches, such as hemiplegic migraines, basilar migraines, or cluster headaches.

Tosymra does not prevent migraines. Tosymra may be safe and effective for children under the age of 18.

Transient Perivascular Injury of the Carotid Artery: An Atypical Cause for Neck Pain

By

AmericanChiro

-

July 3, 2023

0

Specialty

NASCAR road closings cause traffic problems downtown ahead of race.

By

AmericanChiro

-

July 2, 2023

0

CHICAGO(CBS) — The NASCAR racing action is just hours away. But if you’re anywhere near downtown you saw the traffic snarl up as the roads were closed for the race.

CBS 2’s Marybel González reported that it was already a problem for some people Friday evening trying to get into and out of downtown, with roadblocks being set up on busy roads.

This weekend will be a whirlwind of activity, as not only the big race is taking place but also the July 4th celebrations.

There was excitement in the air as the Chicago NASCAR Street Race was about to begin.

Cody Jones, NASCAR engineer, said, “Everyone is driving past where we were parked – windows down and pumping their fists, cheering us on.”

The organizers laid out the red carpet to the adventurous racers.

“I expected it would be cool, but didn’t expect it be as big as it is – you know, the whole town shut down just for us,” said NASCAR driver Corey LaJoie.

But it wasn’t all glitz and glamour. Traffic jams have already been caused by the roadblocks and closings.

Some people struggled to enter the city, while others struggled to leave it.

“We’ve been waiting for a half-hour for a bus because all the routes have been rerouted and there are no other options – we’re stuck,” said a woman at the corner Washington and State streets. “That’s a problem.”

The race was not the only thing that caused the traffic to increase on Friday evening. AAA estimates that nearly 3 million people will be driving for the holiday weekend, a record.

There was a lot of traffic and also heavy security.

On Friday evening, police officers were already standing by at the downtown intersections. CPD also cancelled its days off to prepare for the busy holiday weekend.

Chicago Transit Authority has also put all hands on deck for this busy weekend. The Chicago Transit Authority said that there will be several bus reroutes within the downtown area. You can find a breakdown here.

The CTA recommends that you travel to the race using the ‘L’ train.

Holiday travelers face more weather headaches

By

AmericanChiro

-

July 1, 2023

0

Summary

U.S

Europe

Asia

FX

Rates

Futures

ETFs

Crypto

This copy is only for your personal and non-commercial use. To order presentation-ready copies for distribution to your colleagues, clients or customers visit http://www.djreprints.com.

https://www.barrons.com/articles/holiday-travelers-face-more-weather-headaches-a5b1ec0c

By Hannah Ziegler

June 30, 2023 at 2:00 am ET

Order Reprints
Print Article

Smoke from Canadian fires is spreading across the U.S. as Americans prepare to celebrate the Fourth of July weekend. (Photo by ANDREW CABALLERO-REYNOLDS/AFP via Getty Images)

AFP via Getty Images

The weather is likely to continue to hinder travel plans as millions of Americans prepare for their Fourth of July getaways.

American Chiropractors Directory and News

Back and neck pain relief – Opioids similar to placebo

Why was I having severe headaches and seizures? My Diagnosis Surprised Me

It became a habit

More from Prevention

Not just one, but two diagnoses

What is epilepsy?

Seizures symptoms

No difference was found between the pain severity of low back and neck pain when compared to placebo

Takeaways from the conference:

Read more about

Opioid Resource Center

Know the causes

Quality of Japanese online information on causes of neck pain: A biopsychosocial analysis

Rishi Sunak’s many headaches

DRIVING DAY

BIDEN IS IN TOWN

EDUCATION

MORE LABOUR LAND

Today in Westminster

BEYOND M25

MEDIA RUND

TODAY’S FRONT PAGES

LONDON CALLING

Tonix Pharmaceuticals Completes the Acquisition of Two FDA Approved and Marketed Migraine Product

Transient Perivascular Injury of the Carotid Artery: An Atypical Cause for Neck Pain

NASCAR road closings cause traffic problems downtown ahead of race.

Holiday travelers face more weather headaches

Smoke from Canadian fires is spreading across the U.S. as Americans prepare to celebrate the Fourth of July weekend. (Photo by ANDREW CABALLERO-REYNOLDS/AFP via Getty Images)

Holiday travelers face more weather headaches