If you are living with chronic pain, you know the stress and suffering that results. Chronic pain research continues and treatments still have a long way to go. However, researchers have made some significant gains in understanding and treating chronic pain in recent years, resulting in a new classes of drugs and treatments to help alleviate pain. Today, I am going to discuss some new therapies to explore how you may be able to reduce your pain and improve your life.
To fully comprehend the new treatments, it’s important to review the advances in the diagnosis and understanding of the root causes of chronic pain. Pain specialists now have more understanding of how pain occurs within the nervous system and spinal cord through interactions with the brain and have seen how the neurotransmitter system passes along these signals. Neurotransmitters are the chemicals that transmit nerve signals from parts of the body to the brain, and researchers are learning how to manipulate these signals to change the way they interact with the brain. Many antidepressants have been found to be effective even in low doses for treating the complicated relationship between pain and emotion, providing relief for some who suffer chronic pain. MRI imaging has shown the very real effects these drugs have on the brain and the reduction or even cessation of pain. Functional MRI’s are increasingly able to map the locations in the brain where certain types of pain are activated, providing a map for the causal factors of pain and allowing the development of targeted drugs and therapies that are effective at eliminating this stimuli.
Mapping has also allowed researchers to better understand a process called central sensitization as well. This phenomena occurs when the initial pain from an injury is not treated satisfactorily, causing the nervous system to repeatedly send the pain signal to the brain. This constant barrage of pain signals leads to fundamental changes in the central nervous system, causing it to become more and more sensitive eventually to the point where even the slightest stimulus can cause excruciating pain.
Research has led doctors to more effectively and specifically treat chronic pain in their patients. There are many different types of chronic pain, and every case requires its own specific treatment – which is one of the most confounding issues when trying to treat patients experiencing chronic pain. Some of the classes of pharmaceuticals that have been found effective in combating severe chronic pain range from anti-inflammatories, anti-anxiety drugs, anticonvulsants, antidepressants, muscle relaxants, to opioids. Opioids are well known in treating chronic pain, along with their danger of addiction and abuse. Inflammation is often cited as the most common underlying cause of chronic pain that may respond to treatments. Anticonvulsants have been effective in treating chronic pain for reasons that are still being explored. Antidepressants have been shown to be effective in low doses to adjust the levels of the pain transmitting chemicals in the brain. Even topical pain relief creams have improved in recent years to combat chronic soft tissue pain. These creams utilize capsaicin to reduce the transmission of pain-relaying chemicals to the brain. Capsaicin is also available through skin patches, as well as transdermal patches that contain lidocaine. All of these medical advances have served to reduce or replace some of the case needs for continuing opioid treatment. We touched on this controversial topic in a previous blog post.
Aside from new advances in medications, there are also several new procedures that have been able to alleviate chronic pain for some cases.
- Nerve blocks have been used for years to help combat pain with varying efficacy. While many doctors advocate their use, there are some who say that nerve blocks are ineffective or too short-lived to make much of a difference. Advances in imaging techniques have shown that many of the short-lived or ineffective blocks may be simply due to improper needle placement during the injection and new imaging techniques enable doctors to be more accurate. Arguments for and against nerve blocks continue, but most doctors agree that they can still be an important part of a multidisciplinary approach to chronic pain treatment.
- Peripheral-nerve stimulation involves implanting a very small device that sends a minute electrical impulse to the specific nerves carrying the pain signals. These stimulation devices are similar to the technology used in pacemakers. The impulses “trick” the brain, often causing a slight tingling sensation instead of pain. This has been especially useful in cases involving back pain, neck pain, and complex regional pain syndrome.
- Repetitive transcranial magnetic stimulation is a procedure that is far more experimental than the others mentioned here, but it’s showing great promise in studies. rTMS is currently used to treat depression and peripheral nerve stimulation but has also been shown to disrupt more disbursed pain pathways as well, even such as Fibromyalgia. To essentially simplify this procedure, a coil is placed outside of the patient’s head and an electrical current is run through it which creates a magnetic field that causes electrical changes in the brain. Researchers believe pain is disrupted by the stimulation causing the motor cortex to override sensory perceptions in the brain.
Other therapies are currently being tested for use in chronic pain patients, but they aren’t yet ready for widespread use or are still being tweaked for effectiveness. Progress will be improved if we fund the research and development of these therapies. Chronic pain accounts for 10% of all health expenditures yet only receives 1% of medical research funding in the United States. In order to fundamentally change the way chronic pain is treated and diagnosed, opinions on the seriousness and treatability will need to change to result in a greater commitment in research and development. But in the meantime, the therapies being used today combined with new advances are helping more chronic pain sufferers experience some relief.
For more information on how these treatments may affect your disability claim, or for any other issues resulting from your benefit claim, please visit our website for a free consultation or call our offices toll-free at (855) 828-4100.