Tuesday, December 29, 2009

Advances in Pain Relief


Since chronic pain is a fact of life for anyone with CFS &/or FM,
this article may provide some useful ideas for treatments.
This article is in Medscape, which is free to sign up for. There are
no newsletters or other email, and no 3rd-party emails, that
automatically come with sign-up. You can choose to have specific
newsletters sent (such as one on pain control), simply by checking
off the proper box when signing up, or when reading thru the article.

I have only copied page one (of six) below. Further pages briefly
discuss specific drugs, devices and treatments that can help with pain relief.

Chronic Pain Relief: New Treatments
New advances in drugs and technology mean there are now better
solutions for chronic pain relief.

By Jeanie Lerche Davis
WebMD Feature
Reviewed by Brunilda Nazario, MD

If you're living with chronic pain, here's important news. Today's
pain specialists have sophisticated new treatments -- from effective
drugs to implants and electrical stimulation -- to provide chronic
pain relief. There's much that can be done to tame the beast.

These advances have emerged in the past several years, as researchers
have gained a greater understanding of chronic pain and how it
develops. The origins of chronic pain are all too familiar: sports
injuries, back injuries, car accidents -- or health conditions like
migraines, diabetes, arthritis, shingles, and cancer.

At times, however, there is no obvious cause of the chronic pain, no
trauma or injury people can point to as a source of their chronic
pain problem -- which has been frustrating for both patients and their doctors.

The Roots of Chronic Pain -- and Relief

In past generations, people often heard that chronic pain was "all in
their heads," says Rollin M. Gallagher, MD, MPH, director of pain
management at the Philadelphia VA Medical Center.

Today's pain specialists understand how the sensation of pain occurs
-- how the nervous system, including the spinal cord, interacts with
the brain to create that sensation, Gallagher says.

Insights into the neurotransmitter system -- the chemical messengers
that pass nerve signals -- have opened the door for important new
modes of chronic pain relief, he explains. In recent years,
scientists have learned how to manipulate those chemical messengers
to change the way they interact with the brain's signals.

That's led to use of antidepressants and other drugs that work with
specific brain chemicals that affect emotions, and help with
perception of pain. "We now have a whole new host of medications that
are very effective" for chronic pain relief, Gallagher tells WebMD.

And with advances in MRI imaging, researchers can clearly demonstrate
that the changes are very real in the brain,
he says. "We can show
exactly where the sensation of pain is occurring in the brain when it
is activated by stimuli. We can see the effects of pain on emotion --
and emotion on pain."

There's new understanding, too, of a process called "central
sensitization," says Kwai-Tung Chan, MD, a pain specialist and
professor of physical medicine and rehabilitation at Baylor College
of Medicine in Houston. "If initial pain from an injury is not
adequately treated, those pain signals are sent repeatedly -- which
leads to changes in the central nervous system, making it more and
more sensitive. Over time, even the gentlest touch can become very painful."

Pain Specialists: Experts in Chronic Pain Relief

With these insights, pain specialists now prescribe treatments that
attack moderate-to-severe chronic pain from different angles --
innovative drugs, targeted nerve-zapping procedures, and drug pumps
that deliver strong painkillers to the nerve root. Doctors also
endorse the use of psychotherapy, relaxation techniques and
alternative therapies, supported by growing evidence of the mind-body
connection in chronic pain relief.

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