New research is taking a closer look at the drugs targeted at physical pain and how they might affect other aspects of behavior and emotional experience.

One study in 2010 found that acetaminophen,the active ingredient in Tylenol, reduces behavioral and neural responses associated with the pain of social rejection. The study feels that because the drug can help both types of pain, there is a large overlap between social and physical pain.

Dubbed the “pain related affect”, researchers are looking into “subjective feelings or impressions of anguish that accompany almost any harmful stimulus.” In other words, it is not only physical sensations that register as pain, but emotions and social distress that can hurt as well. In fact, “hurt feelings” result in the same firing of neural pathways.

Acetaminophen has always stood apart from other mind-altering pain killers such as opioids as it was not thought to influence a patients emotions or mental state. As this widely used over-the-counter drug is considered relatively benign (aside from conditions that result from over use) it has become one of the most commonly used drugs for pain on the market.

However, recent research shows that Tylenol does in fact alter moods and may moderate feelings of anxiety. The study above found that participants taking acetaminophen responded less to scenarios of social rejection than those taking the placebo. These studies garnered much attention and interpretation in the media and are an interesting contribution to the discussion of how the brain interprets pain. For more of this topic see the links below.


Since hosting a continuing medical education seminar, some of our physicians have started to work more closely with Apollo Applied Research, and have offered the service to patients. One of these patients was recently seen in a follow up encounter, and the physician forwarded us all a small note about their findings:

Dear Colleagues:

I wanted to share with you an amazing success story.

A patient presented with chronic and persistent upper right shoulder pain for the last 18 months. A number of pharmacological therapies were prescribed…

Pain persisted despite these attempts.

As a last resort, I prescribed the patient medical cannabis through Apollo Applied Research, and the patient has reported a considerable decrease in pain with no psychological impact. The patient has reported they have stopped using all other pain medications for this chronic ailment.

The patient has also reported a significant improvement in her quality of life, indicating that her sleep has improved, and she feels able to exercise for the first time in many years.

While of course this is NOT evidence, a case study or anything more than ONE instance of positive feedback about Apollo’s project yielding positive results for ONE patient, it is an encouraging experience for one patient in an area we are all learning more about… and it is another person no longer using painkillers and opioids… and that alone is worth sharing.


ECHO Ontario is a joint project between University Health Network and Queen’s University Continuing Professional Development Office to replicate the Project ECHO developed at the University of New Mexico. The goal is to empower primary care physicians to treat patients more effectively by granting better access to specialists.

The “Hub” practitioners of the program are reputed to be very strong and we know Dr.Andrea Furlan – she’s a highly respected member of the pain community.

Here are some videos on the project.


Apollo Applied Medical Marijuana Research is at Allevio Pain Management this evening discussing their Medical Cannabis research project for patients with Chronic Pain.
This is a small CME event that was geared to our specialists, but was also attended by some primary care practitioners and Anesthesiologists working with three UHN / University of Toronto affiliated hospitals.
There’s a ton of great and detailed information about this product and the best practices when it comes to finding the right strains for patients. For more information about this, and to find out if the Apollo study or clinic is right for you, please get in direct touch with your physician or with Apollo directly.


Marie J. Hayed, PhD, and Mark S. Brown, MD have published an article in JAMA Internal Medicine that notes as Medical Marijuana prescriptions increase in a given community, so too do opioid-related deaths decrease. (Opioids are pain killers such as Oxycodone, Oxycontin, Vicodin, Percocet and Dilauded).

From the UofC, Berkeley Wellness Letter, Feb 2015:

…the 13 states which medical marijuana laws between 2000 and 2010 had a 25% lower opioid-related death rate, on average, than states where marijuana was illegal. The longer the laws were in effect, the greater the reduction. The researchers estimated that in 2010 there were about 1,700 fewer opioid-related deaths than would be have been expected if medical marijuana had not been available.

An important statistic as so many physicians are nervous about choosing the proper medications for patients, and an important tool in the ongoing battle to combat pain killer abuse.

While Allevio does not prescribe medical marijuana (or manage pharmaceuticals for patients generally), the Apollo Applied Research program for Medical Marijuana is the program we tend to refer to. The program is ethics-approved and does not charge patients for prescriptions.


For our UK readers, this is a list of active and past clinical trials of Osteopathy for different health conditions, including but not limited to low back pain, back pain, shoulder pain, neck pain, TMJ and migraine headaches.  This list is powered by the NHS (National Health System) and WHO (World Health Organization) International Clinical Trials Registry.

Many of our Allevio patients turn to Osteopathy as part of their multi-disciplinary approach to their chronic pain, rehabilitation or re-conditioning with a sports injury.  For more information about Osteopathy, click here.


Over the past number of weeks, the Toronto Star has published a series of videos and articles about several patients who, under the care of the Rothbart Centre, have contracted bacterial meningitis and epidural abscess, among other complications. We join our patient community, the physician community and of course our entire community in extending our deepest sympathies to the patients and their caregivers for what has happened.

At Allevio, our main focus is to keep patient care and safety as our primary concern.  We are currently adding new physicians to our team to accommodate the increasing need for evidence-based interventional pain management in Toronto.  We adhere to all Public Health guidelines, and go beyond the standards wherever possible. You can find our (and other clinic’s) College of Physicians and Surgeons of Ontario (CPSO) Out of Hospital Premises inspection findings here. We were granted a “Pass” when inspected.

The result: Standards and procedures that are safer for patients and practitioners, an understanding of proper protocol that goes above and beyond, and a patient safety record that reflects our commitment to outstanding care.

For patients who have recently been treated at the Rothbart Centre who chose to receive care at Allevio Pain Management, we are of course happy to see you, but ask you to:

  1. Speak to your Family Doctor for medical clearance if you are concerned about infection
  2. Ask your Family Doctor to complete our Referral Form
  3. Complete our Pre-Consult Questionnaire
  4. Check with the CPSO (College of Physicians and Surgeons of Ontario) to see if they have additional recommendations for patients who have been treated at the Rothbart Centre.


Dr. Mike Evans of St. Michael’s Hospital in downtown Toronto published an extensive must-watch video for anyone taking, considering, or giving care to a patient on opioids.  The video answers a lot of questions about these type of pain-killing drugs, and the pitfalls that can be associated with treatment.

Dr. Evans mentions that before you try opioids, consider trying other methods of managing your pain. As a pain clinic in Toronto, we see a number of patients come in with chronic pain conditions who considered opioids but instead started seeing our Osteopath or Chiropractor for manual therapies, acupuncture, etc. They also discuss nerve block interventions with our Anesthesia-trained pain management physicians. For many of Allevio’s chronic pain patients, the options they discovered and improvement they say saw kept them from starting opioids in the first place.

If you have, or care for, someone with chronic pain, drugs are not the only answer. Please watch this video, post it and pass it on to those you know who have pain-related complications and may use opioids.  The background and advice in it is very worthwhile.


Radiculopathy is a set of conditions where a nerve does not work (and send pain signals to the brain) properly.  With this type of a condition, the problem with the nerve may be localized close to the spine, but the pain or sensation of pain can radiate from that place through the where the nerve ends (such as through an arm or down a leg). The image shows where the pain may be felt through the arm.

Neuropathic pain and Radiculopathy can come from pressure through a ruptured disc, degenerative bone conditions, arthritis or other injuries that put pressure on the nerve roots. In middle-aged people however, normal degenerative changes in the discs can cause pressure on nerve roots.

Neck And Arm Pain is an infographic put together by Mount Sinai hospital in New York, and it’s worth looking at.

While not specific to neuropathic pain, the poster points out several important points and tips:

  • Exercise and keep your weight under control, but don’t strain your neck or do anything too aggressive.
  • Don’t smoke
  • And of course, see your doctor if your pain lasts longer than 8 weeks, you experience neck or back pain along with pain across other extremities, you have numbness or tingling, or if your muscles aren’t responding as they normally do.

At Allevio Pain Management in Toronto, our physicians can help you understand and decide your best course of actions, and should a procedure make sense, they have specific tools to help them make sure the procedure is done properly.  Be very careful when you have any work done to your neck or spine that is being done properly by specialists, and that they are using proper tools to help them.


More than managing headaches and chronic pain, Allevio is here to help you get your life back. Our services are completely geared to offering you the best relief available.

Our Flagship Location

240 Duncan Mill Road Main Floor Suite 101 Toronto, Ontario M3B3S6

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