Normalization of Serum Cortisol Concentration With Opioid Treatment of Severe Chronic Pain

Authors


  • Reprint requests to: Forest Tennant, MD, Dr PH, Veract Intractable Pain Centers, 338 South Glendora Avenue, West Covina, CA 91790. Tel: (626) 919-7476; Fax: (626) 919-7497.

Abstract

Serum cortisol concentrations may be altered in severe, chronic pain due to excess stimulation of the hypothalamic-pituitary-adrenal axis. Among 40 consecutive patients with severe, chronic pain 26 (65.0%) demonstrated abnormal serum cortisol concentration. After 90 days of treatment, only 7 (17.5%; p<0.01) continued to show abnormal serum cortisol concentration indicating that serum cortisol and other serologic abnormalities may serve as biologic markers of severe, chronic pain.

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