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Another hot target for chronic pain is the modulatory system that humans have evolved to suppress pain when necessary--so that they can run from a predator while wounded, for example. Preliminary evidence suggests that chronic pain sufferers aren't good at recruiting this inhibitory system. Indeed, ongoing studies suggest that people with chronic pain may be hyperactive in the opposite direction: they amplify pain signals on their way to the brain. Sean Mackey, a physician and researcher at Stanford University, and his colleagues are now studying the brain stem and spinal cord, two crucial components of this modulatory system that have traditionally been very difficult to assess with fMRI. These parts of the nervous system move with every breath and heartbeat, so the researchers had to develop new analysis methods to generate clean images.
Identifying the neural signatures linked with chronic pain may also provide a new way to screen experimental drugs for human testing. A small study of pain patients given gabapentin--an epilepsy drug also used to treat nerve pain--showed significant activity changes in the parts of the brain that respond to pain. Drug developers could use this measure as a quick way to assess which experimental compounds to send for further testing, says Tracey, who is developing the technique. "We are getting to the point where we can test novel compounds."
In the absence of effective drugs, many chronic pain patients have turned to behavioral therapies to try to control their pain. Tracey's studies have shown that people who are better at distracting themselves from pain show more activity in a specific part of the pain modulating system. "Maybe we could use brain imaging as a screening tool to determine who would do well on cognitive behavioral therapy," she says.
One of the newest experimental approaches to controlling pain is real-time fMRI, in which patients watch their brain activity in real time as they try to consciously control brain areas involved in pain. (See "Seeing Your Pain.") Mackey and his collaborators have shown that chronic pain patients could reduce their pain in the short term using this method--essentially, a more precisely targeted form of biofeedback--and the researchers are now assessing long-term effects. Mackey says that brain-imaging studies of these patients are shedding light on how people learn to control their pain, and which parts of the brain are the most effective targets.
Scientists don't yet know why some people develop chronic pain and others don't. "There seems to be cortical reorganization at a high level because of the injury itself, but whether that's a coping mechanism or just a consequence, we don't know," says Apkarian. "Some people might be predisposed to chronic pain. But it still seems to get worse as they live with the pain."
He and others say that one of the biggest benefits to brain-imaging studies of chronic pain is that they convince both patients and doctors that it really exists. "It's been revolutionary in providing validation to people that pain is something with a real neurological basis," says Mackey. "We can point to areas of the brain and say, That's part of the brain that's dysfunctional."
Researchers use brain imaging to detect patterns of brain activity associated with pain—a potential boon for doctors and drug developers.
RFID technology allows neural stimulators to get really small.
A treatment, now being tested in humans, may avoid the disabling side effects of opiate drugs.
I'm feel you pain and I know it's real. My impression about pain is multi factoral. First there are different cultural tolerances to pain. Mexican women with indigenous indians genes, are very tolerant to pain... yet, latin men, will climb the wall just when you show them a needle.
English and northern german's seem to have a high tolerance for pain, more so than those further south, spain and italy.
In addition, low pain tolerance is higher in the patient as I put it, have been put up with crhonic illnesses... these patients have been punched and poked so much, that it seems that they just can't take it anymore.
My gut feeling is that chronic pain, is an autonomic nervous system learned response. Think Phantom Pain, that amputees have. With this caveat I feel that the neural pain tracks are get programed to feel pain... and work has been done to reprogram these neural tracks, or to bypass these track to allieviate the chronic pain. It involves functional MIR's where the pain is visualised and the patient is taught to think about another focus in the brain, and this in time reprograms nerual tracks around the site elicting the pain.
This is relative new reserach and I donlt know who is doing this, but a google search may help.
In the 20th century, we were taught, and believed that the brain was static and fixed, and could not be changed. The 21st century will be the century of learning how to remold the brain's neural pathways around the deficits.
The brain is plastic and malleable. It's a fantastic concept and I expect great and rapid changes.
Ironically, we knew this in the 20th century but didn;t really believe it. for example, physical therapy can rewire a brain damaged by a stroke. Just look at Kirk Douglas and his ability to learn how to talk again after his stroke.
So, don't dispair. help is on the way.
ron hansing.
after 30years and 12 back surgeries,countles pain med. treatments,epid,acup,phisical therapy, i found a pain clinic in Israel at the sheba hospital under the care of Dr. Adahan. i can say they are aproaching my problem with phisical and mental therapy including Bio-feedback. I have had a month and can tell you i have improved alot.From taking large dosage of morphine med everyday to almost, three time a week.I can say that I had decided this was my last chance to get back to a normal live.Learn how to live with pain, control the pain mentaly, and less med.
My Name is Lucas Harley from Cph. Denmark (Capitol)
I am a Civilengineer working with Static correction of Human Body for at least 10 years
My Company name is Cental ltd. UK, office Denmark at Rovsinghus
I adress 'musclespasm', chronic pain syndrome and recovery from disc failure for inst. in L5/L4
WHO R25.2 ICD ver. 2007, non hereditary.
Cause 210852; SBS building syndrome with Mold, Fungia, Humidity high, water logged in Walls and in basement below,
Start Hamstrings compressed violently, due to lack of sleep, humid conditions, air drag and low temperatures on
Floor ( 13 degrees C, 21 degree C at 1 meter level above floor).
On one Patient 210852 we have disclosed spasm in Piriformis, Glut. med. and in 3+1 Hamstrings (L) left Leg only
- then in Back problems in Trapezius, Latissimus Dorsi, Muscles at Sacral Bone and torque in
left part of Pelvis.
Numbness in Peroneus Longus (L), Tibialis Anterior Muscle atrophy (L).
We have for the last year observed a large quantity of pain releases and following Brain Pain Pattern changes,
at least twice a month - as we did chiropractical Aid in Steps.
Release 1; Right Buttock and immidiately under
R2; Left Buttock top ( Glut. max. )
R3; Left Leg inner Hamstrings, Gracilis, Semitenendinosus, Semimembranosus
R4; Left Trapezius area, sharp pain removed ( Anaesthetized )
R5; Angle between right Leg and Body opened from 83 to 90 degrees ( sharp click in Hamstrings )
R6; Left Shoulder muscles opened and lengthened
R7; Right Glut. Med pain at Buttock top removed
R8; Virtual Line between left shoulder and Glut. Med in Right Side lengthened
R9, Virtual Lines, cross left/right and Right/left same length after treatment 1)
R10; All muscles in Pelvic floor realeased and extended to proper work Condition lenght
R11; Mechanism at Pelvic floor for stopping urine flow reestablished proper ( before 10% untimely spill)
as a follow up we check the curvature of L1 to L5, in 2003 that virtual Line was straight ( no curvature ).
Patient could not sit properly unless cramp was released in left Leg, Semitendinosus muscle Shank before 1 minute
sitting everywhere, Busses, Trains,Cars, Office chairs...
Brain;
We observed a change in Brain action Pattern, as the different areas of the Brain, primeraly the left and right side,
top of Brain Sphere and at the frontal Lobe -
- when pain was diminished the Brain was experiencing a flow of 'cold' liquid, or prickling sensation or both -
afterwards the virtual Capacity and multitasking Cap. went up some 3-5 % each time the flow was observed.
Is there world wide acceptance of pain relief causes that sensational experience in the Brain?
Is that sensation Pattern, described, a normal one?
- can it be explained according to Nerve system signalling ( Matter, Tracers, volume )?
We have found, in an earlier Medical Journal of medicine, that excessive manipulation of muscles cause
release of Histamine, neurotransmitters and soundry chemical Matters. Our patient has witnessed a large
amount of itching in both Legs after manipulation; massages, strecthing, elastic band training, weight use
to the limit of endurance, especially the Calves have been hit - it itches for 10 minutes unbroken, very
sharp and intense itching, like burning under Skin, and at Ankles + both Shins.
Regards Lucas
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Guest (dib)
Pain
I had an accident hicking in '65. My back's been worse every year thereavter. I use guided meditation to keep my pain around 7 ou 8 because I must know when it's sharply rising. At 10 I black out (broke a foot once and a clavical another time passing out on the stairs).
So, what I need is back repair. I've been working on this problem for 40 years. No one knows what's wrong. If this sounds familliar to anyone please email me.
dib
dib_at_home@comcast.net
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