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By Perri Klass, M.D. I believe my mother thought that needing to medicate her own discomfort would be a kind of moral and physical weakness. This applied only to herself; if I told her that I was hurting, or that one of her grandchildren was in pain, she would have been anxious for something to help. She felt our pain, you might say, but she denied her own. I’ve spent the past couple of weeks thinking about pain in children and writing about pain in children — acute pain and chronic pain, pain with shots and pain after surgery, pain medicines and pain specialists. I asked the pain experts I interviewed about the different ways that different people experience pain from the same stimulus: Why does one child cry inconsolably after a needle stick while another, same age, same size needle, watches with curiosity as the shot is administered and doesn’t even flinch? There is a great deal of variation in how much pain people experience, I was told, and by and large we should take people at their word. Some people are more prone to soreness, some are relatively less sensitive, some hypersensitive, and there are differences in the ways that different people process pain, and in the ways they respond to drugs. And “hypersensitive” is not a code word for “complains more” — it’s a neurological category. And then of course there are psychological factors. That is not to say that pain is psychogenic, said Dr. Charles Berde, the founder of the division of pain medicine at Boston Children’s Hospital, and one of my teachers when I did my training there. People who are anxious or terrified of pain, people who have post-traumatic stress disorder, may actually experience more pain, he said, because the pain circuits in their brains are revved up. © 2019 The New York Times Company

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25931 - Posted: 02.04.2019

By Perri Klass, M.D. Acute pain that calls out to warn you — “Hey, don’t walk on this broken leg!” — may be unpleasant, but it’s also protective. That acute pain is letting you know that a part of your body needs to heal, or in some other way needs extra attention, said Dr. Neil Schechter, the director of the chronic pain clinic at Boston Children’s Hospital. That’s very different, he said, from chronic pain that goes on over the course of months, whether abdominal pain or headache or musculoskeletal — it may persist and be incapacitating, because “the pain has become the disease.” That doesn’t mean the pain is any less painful for the person experiencing it. “There is really strong evidence supporting the psychological treatment for chronic pain, and that doesn’t imply that the pain itself is a psychological problem,” said Rachael Coakley, a psychologist who is the director of clinical innovation and outreach in pain medicine at Boston Children’s Hospital. Her book, “When Your Child Hurts,” is an excellent resource for parents. “When you’re a kid and you’ve had pain for a really long time, a lot of that is an experience of not having control over what’s happening in your body,” said Anna C. Wilson, a pediatric pain psychologist at Oregon Health and Science University. “Relaxation and other biobehavioral techniques help kids gain a sense of control.” She tells patients, “Your pain is absolutely real, and chronic pain in particular is a neurologic problem.” She recommended TED Talks by Dr. Elliot Krane, an anesthesiologist, and Lorimer Moseley, a neuroscience professor, to help explain chronic pain. Chronic pain develops, Dr. Schechter said, when there is an underlying biological vulnerability, either inherited or resulting from stressors like infections or procedures or traumas, and then a triggering event, such as a gastrointestinal infection or an injury. © 2019 The New York Times Company

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 13: Memory, Learning, and Development
Link ID: 25887 - Posted: 01.21.2019

Jonathan Lambert Pain is a complicated experience. Our skin and muscles sense it, just like they sense softness or warmth. But unlike other sensations, the experience of pain is distinctly unpleasant. Pain has to hurt for us to pay attention to it, and avoid hurting ourselves further. But for people in chronic pain, the pain has largely lost its purpose. It just hurts. While it has long been understood how nerves signal pain to the brain, scientists haven't known how the brain adds a layer of unpleasantness. Findings of a study published Thursday in Science offer an answer. A research team from Stanford University pinpointed the neurons in mouse brains that make pain hurt and were able to alter these neurons in a way that reduced the unpleasantness of pain without eliminating the sensation. The study lays the groundwork for future research into more targeted pain treatments. "This study is a major advance," says Irene Tracey, a pain neuroscientist at Oxford University who wasn't involved in the study. "It was a tour de force and a welcome addition to understanding this complex and major problem." Stanford neuroscientist Grégory Scherrer, who co-led the study, started the search for pain neurons in the amygdala — the slim, almond-shaped region scientists know regulates many emotions. The challenge for Scherrer was to sift through the tangle of neurons there and identify the ones associated with pain. © 2019 npr

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25884 - Posted: 01.19.2019

Emily Chung · CBC News · Could the pain you feel in your body be all in your head? At least some of it might be — if you're a man (or a male mouse), a new study has found. Male humans and male mice — but not females of either species — both became hypersensitive to pain when put in an environment where they had previous had a painful experience, reports a new Canadian-led study published last week in the journal Current Biology. "The sex difference was completely unexpected," said Loren Martin, the University of Toronto Mississauga assistant professor of psychology who led the study. While there was no reason to believe males and females would respond differently, if they did, he would have expected females, not males, to develop pain hypersensitivity, since they're generally more sensitive to pain and more prone to chronic pain. Martin originally ran an experiment on mice while he was a postdoctoral researcher in the lab of McGill University professor Jeffrey Mogil, who holds two research chairs related to pain. They wanted to to see how the mice would react if brought back to a place where they had had a painful experience — a 30-minute tummy ache cause by dilute vinegar in their stomachs — and whether they could be conditioned to be hypersensitive to pain. The reason they were interested is because there is growing evidence that chronic pain is linked to biochemical "rewiring" in nerves similar to what happens with the formation of memories in the brain, and may itself be akin to or linked to memory, Martin said. If that's the case, chronic pain could potentially be treated by de-rewiring the nerves back to their normal state. ©2018 CBC/Radio-Canada

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 12: Sex: Evolutionary, Hormonal, and Neural Bases
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 8: Hormones and Sex
Link ID: 25864 - Posted: 01.15.2019

By Perri Klass, M.D. Pain control in infants and children has come a long way over the past few decades. Experts know how to provide appropriate anesthesia when children need surgery and understand the ways that even very young children express distress when they’re hurting afterward. There is a lot of evidence about reducing the pain and anxiety that can accompany immunizations and blood draws, and there is increasing expertise about helping children who struggle with chronic pain. But today’s parents may be shocked to learn that was not always the case. As recently as the early 1980s, the pain of children and infants was thought to be different from that of adults and was sometimes treated differently, or sometimes not treated at all. Change doesn’t always come easily in medicine, so there’s a certain onus on parents to make sure that their children get state-of-the-art pain management around procedures, large and small. That means preparation before any planned surgery, ideally with a child life specialist, and it means careful attention to the child’s pain afterward, with parents well backed up by medical specialists. Let me start in the bad old days: About 30 years ago, when I was doing my residency, my 4-year-old son fractured his femur. After surgery, he found himself on the orthopedic ward of my very own hospital, and in a fair amount of pain (the femur is the biggest bone in the body, and there was a lot of tissue damage). As his busybody on-call pediatric resident mother, I discovered that the pain control ordered by the surgeons was “IM MSO4 PRN.” That meant he could have an intramuscular dose of morphine whenever the pain from the fracture was so bad that it overcame a 4-year-old’s fear of shots. To get pain relief, he would have to request the needle. © 2019 The New York Times Company

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 13: Memory, Learning, and Development
Link ID: 25854 - Posted: 01.10.2019

Gently stroking a baby reduces activity in their brain associated with painful experiences, a study has found. The study, by University of Oxford and Liverpool John Moores University, monitored the brain activity of 32 babies while they had blood tests. Half were stroked with a soft brush beforehand and they showed 40% less pain activity in their brain. Author Rebeccah Slater said: "Touch seems to have analgesic potential without the risk of side-effects." The study found that the optimal pain-reducing stroking speed was about 3cm (1in) per second. "Parents intuitively stroke their babies at this optimal velocity," said Prof Slater. "If we can better understand the neurobiological underpinnings of techniques like infant massage, we can improve the advice we give to parents on how to comfort their babies." That speed of stroking activates a class of sensory neurons in the skin called C-tactile afferents, which have been previously been shown to reduce pain in adults. But it had been unclear whether babies had the same response or whether it developed over time. "There was evidence to suggest that C-tactile afferents can be activated in babies and that slow, gentle touch can evoke changes in brain activity in infants," said Prof Slater. Prof Slater said the study, published in Current Biology, could explain anecdotal evidence of the soothing power of touch-based practices such as infant massage and kangaroo care, where premature babies are held against the skin to encourage parent-infant bonding and possibly reduce pain. © 2018 BBC.

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25795 - Posted: 12.18.2018

By Kelly Servick If you’ve ever unwittingly grabbed a hot pan, you know our bodies have exquisite reflexes for avoiding or minimizing injuries. But once the damage is done, we also have a spontaneous urge to sooth the pain—to blow on a burned hand, cradle a broken toe, or suck on a cut finger. A new study reveals a neural circuit behind this soothing response in mice. Many common animal tests of pain don’t involve this circuit, the authors contend, which could explain why some painkillers that seem to work in mice prove ineffective in people. “We know there is not just one ‘pain pathway’ or a single brain site involved in processing pain,” says Kathleen Sluka, a neuroscientist at the University of Iowa in Iowa City, who was not involved in the new work. “Understanding the different pathways that underlie unique behaviors could one day help us to individualize treatments” for patients based on how they respond to pain. Harvard University neurobiologist Qiufu Ma and his team wanted to tease apart different aspects of pain, not just in the brain but in the neurons throughout our bodies that relay signals up the spinal cord. Ma and his collaborators previously proposed two general groups of sensory neurons: ones that project to the outermost layer of skin and ones that branch to deeper tissue throughout the body—the underlying skin layers, bones, joints, and muscles. Ma suggests the first group is a first-line defense that monitors our surroundings for danger and prompts us to pull away from a hot pan or a sharp prick. The deeper nerves, he suggests, are attuned to the lasting pain of an injury or illness—and may drive the experience of unpleasantness and distress that comes with pain. Our reflexes avoid potential harm, Ma explains; “the suffering of pain is very different.” © 2018 American Association for the Advancement of Science

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25774 - Posted: 12.11.2018

By Sarah Vander Schaaff Nancy Baum Lipsitz remembers the night the pain began. She’d had a glass of white wine with a friend and went to bed with a terrible headache. The next day, she still felt horrible, the beginning of what she called a “rolling tide” of near constant migraines and lower level headaches. For three years she dealt with the symptoms. Sometimes she got tunnel vision, or a visual aura, a warning that a big headache was on the way. Those felt like “someone taking a pick and jabbing it through my nose and eye,” she said. Then there was the vomiting, numbness and sensitivity to light and noise. Her speech slurred. Less severe headaches felt like a “hangover.” She stopped exercising, socializing and overseeing her 15-year-old daughter’s homework, relying instead on her daughter to take care of her, bringing an ice pack, medication or whatever else she needed when a migraine attacked. “Everything you are as a human being gets stripped away,” Lipsitz said of what was ultimately diagnosed as refractory migraine. The one thing she did not give up was her work. As director of anesthesiology at Carnegie Hill Endoscopy in New York, she knew patients and staff depended on her. “I am not going to let a migraine shut me in the bedroom,” she said. She showed up at 6 a.m., no matter the pain. © 1996-2018 The Washington Post

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25745 - Posted: 12.03.2018

Exposure to uncomfortable sensations elicits a wide range of appropriate and quick reactions, from reflexive withdrawal to more complex feelings and behaviors. To better understand the body’s innate response to harmful activity, researchers at the National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health, have identified activity in the brain that governs these reactions. Using heat as the source of discomfort, experiments conducted by the center’s intramural program showed that bodily responses to pain are controlled by a neural pathway involving heightened activity in the spinal cord and two parts of the brainstem. Results of the study were published in the journal Neuron. “Much is known about local spinal cord circuits for simple reflexive responses, but the mechanisms underlying more complex behaviors remain poorly understood,” said Alexander T. Chesler, Ph.D., a Stadtman Investigator at NCCIH and senior author of the study. “We set out to describe the brain pathway that controls motor responses and involuntary behaviors when the body is faced with painful experiences.” Just as people respond to increasingly uncomfortable surfaces like a sandy beach on a hot day by lifting their feet, hopping, and eventually running to a water source, so, too, do laboratory models show a predictable sequence of behaviors. Experiments showed that the parts of a brainstem involved in this circuit are the parabrachial nucleus (PBNI) and the dorsal reticular formation in the medulla (MdD). A specific group of nerve cells in the PBNI is activated by standing on a hot surface, triggering escape responses through connections to the MdD. These PBNI cells express a gene called Tac1, which codes for substances called tachykinins that participate in many functions in the body and contribute to multiple disease processes. The MdD cells involved in this circuit also express Tac1. A different group of cells in the PBNI participates in the aspects of the response to noxious heat that involve the forebrain.

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25696 - Posted: 11.17.2018

By Gary Greenberg The Chain of Office of the Dutch city of Leiden is a broad and colorful ceremonial necklace that, draped around the shoulders of Mayor Henri Lenferink, lends a magisterial air to official proceedings in this ancient university town. But whatever gravitas it provided Lenferink as he welcomed a group of researchers to his city, he was quick to undercut it. “I am just a humble historian,” he told the 300 members of the Society for Interdisciplinary Placebo Studies who had gathered in Leiden’s ornate municipal concert hall, “so I don’t know anything about your topic.” He was being a little disingenuous. He knew enough about the topic that these psychologists and neuroscientists and physicians and anthropologists and philosophers had come to his city to talk about — the placebo effect, the phenomenon whereby suffering people get better from treatments that have no discernible reason to work — to call it “fake medicine,” and to add that it probably works because “people like to be cheated.” He took a beat. “But in the end, I believe that honesty will prevail.” Lenferink might not have been so glib had he attended the previous day’s meeting on the other side of town, at which two dozen of the leading lights of placebo science spent a preconference day agonizing over their reputation — as purveyors of sham medicine who prey on the desperate and, if they are lucky, fool people into feeling better — and strategizing about how to improve it. It’s an urgent subject for them, and only in part because, like all apostate professionals, they crave mainstream acceptance. More important, they are motivated by a conviction that the placebo is a powerful medical treatment that is ignored by doctors only at their patients’ expense. And after a quarter-century of hard work, they have abundant evidence to prove it. Give people a sugar pill, they have shown, and those patients — especially if they have one of the chronic, stress-related conditions that register the strongest placebo effects and if the treatment is delivered by someone in whom they have confidence — will improve. Tell someone a normal milkshake is a diet beverage, and his gut will respond as if the drink were low fat. Take athletes to the top of the Alps, put them on exercise machines and hook them to an oxygen tank, and they will perform better than when they are breathing room air — even if room air is all that’s in the tank. Wake a patient from surgery and tell him you’ve done an arthroscopic repair, and his knee gets better even if all you did was knock him out and put a couple of incisions in his skin. Give a drug a fancy name, and it works better than if you don’t. © 2018 The New York Times Company

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25655 - Posted: 11.07.2018

Ever wonder why things that normally feel gentle, like putting on soft shirts, are painful after a sunburn? In a study of four patients with a rare genetic disorder, NIH researchers found that PIEZO2, a gene previously shown to control our sense of our bodies in space and gentle touch, may also be responsible for tactile allodynia: the skin’s reaction to injury that makes normally gentle touches feel painful. This and a second NIH-funded study, both published in Science Translational Medicine, used mice to show how the gene may play an essential role in the nervous system’s reaction to injury and inflammation, making PIEZO2 a target for developing precise treatments for relieving the pain caused by cuts, burns, and other skin injuries. “For years scientists have been trying to solve the mystery of how gentle touch becomes painful. These results suggest PIEZO2 is the gene for tactile allodynia. We hope that these results will help researchers develop better treatments for managing this form of pain,” said Alexander T. Chesler, Ph.D., a Stadtman Investigator at the National Center for Complementary and Integrative Health (NCCIH) and a senior author of one of the studies. The PIEZO2 gene encodes what scientists call a mechanosensitive protein which produces electrical nerve signals in response to changes in cell shape, such as when skin cells and neurons of the hand are pressed against a table. Since its discovery in mice by a team led by Ardem Patapoutian, Ph.D., Scripps Research, La Jolla, CA, the lead author of the second paper, scientists have proposed that PIEZO2 plays an important role in touch and pain in humans.

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25563 - Posted: 10.11.2018

Giorgia Guglielmi A study that claims to show that a homeopathic treatment can ease pain in rats has caused uproar after it was published in a peer-reviewed journal. Groups that promote homeopathy in Italy, where there is currently a debate about how to label homeopathic remedies, have held the study up as evidence that the practice works. But several researchers have cast doubt on its claims. The authors acknowledge some errors flagged in an analysis of the paper by a separate researcher, but stand by its overall conclusions. Senior author, pharmacologist Chandragouda Patil of the R. C. Patel Institute of Pharmaceutical Education and Research in Dhule, India, also says that the results are preliminary and cannot yet be applied to people, and that he hopes that the team’s findings will encourage other researchers to conduct clinical studies. Researchers have presented evidence in support of homeopathy before — famously, in a 1988 Nature paper2 by French immunologist Jacques Benveniste that was later discredited. This latest claim has attracted attention, in part, because it passed peer review at the journal Scientific Reports. (Nature’s news team is editorially independent of its publisher Springer Nature, which also publishes Scientific Reports). © 2018 Springer Nature Limited

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25549 - Posted: 10.09.2018

By Michael Mosley Horizon Could taking a placebo, a pill which contains nothing but ground rice, really help cure back pain? The placebo effect is well studied but at the same time something of a mystery. The word placebo comes from the Latin "I shall please" and is associated with images of quack doctors selling dodgy cures. Yet it is also an important part of modern clinical trials, where patients are given either a placebo (sometimes called a dummy pill) or an active drug (without knowing which is which) and researchers then look to see if the drug outperforms the placebo, or vice versa. But what if you decided to do a placebo-controlled trial on back pain, with a twist? The twist being that everyone, unknowingly, was getting placebo? Would people taking the pills get better anyway? That's what we set out to test for BBC2's Horizon programme, Can my brain cure my body? With the help of Dr Jeremy Howick. an expert on the placebo effect from University of Oxford, we set out to see if we could cure real back pain with fake pills. It would be the largest experiment of its kind ever carried out in the UK, with 100 people from Blackpool taking part. Some were asked to act as a "control" group. The rest were told that they were taking part in a study - where they might receive the placebo or a powerful new painkiller. What they weren't told was that they would all get placebos, capsules containing nothing but ground rice. The pills were authentic looking and based on years of research. They were blue-and-white-striped, because that has been shown to have a greatest painkilling effect. They came in bottles, carefully labelled, warning of potential side effects and sternly reminding patients to keep out of the hands of children. All very convincing. © 2018 BBC

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25525 - Posted: 10.04.2018

By Ersilia M. DeFilippis I felt a shake and opened my eyes. The clock read 1:30 a.m. “We need to go to the hospital,” my mother whispered in my ear, clutching her stomach. She knew; it was the same pain she had experienced many times before. We were in California, many miles from home, many miles from my father (a doctor), who always knew what to do. At the time, I was early in my medical school training, although I knew all the intricate details of my mother’s medical history and realized she needed to get medical attention. When we arrived at the local emergency room in an affluent neighborhood, my mother was placed in a wheelchair and taken to the waiting room. She curled up on the cold barren hospital floor, the only position she could find comfortable. Although my mother usually puts on lipstick and high heels to go to the grocery store, this time, her hair was unkempt and her pajamas worn out. Her knees were tucked into her chest and her belly was distended. It should have been clear to onlookers that she was in agonizing pain, but people were hesitant, skeptical even. “Ma’am,” someone yelled. “Ma’am, we can’t have you lying on the floor. Get up.” My mother lay still. “Get up, ma’am,” she was told again, again more forcibly. They helped her back into the wheelchair. “Help me,” she said. “The pain is unbearable.” Reluctantly, they put her in a stretcher and prepared to place an IV in her arm. To convince them the pain was real, we asked them to call my father, who could fill in all of the medical details: her multiple prior hospitalizations, surgeries and diagnoses. © 1996-2018 The Washington Post

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25511 - Posted: 10.01.2018

By Lisa Rein In my first Feldenkrais class, we lay on our backs with eyes closed and drifted our eyeballs left to right and back again. We shifted our heads from side to side as our eyes followed in their sockets. Then we changed it up, moving our eyes in the opposite direction from our heads. This may sound like a simple sequence. It’s deceptively challenging. And it continued for an hour, with sitting variations, eyes alternately open and shut, a brain workout that included tracking our thumbs as our bent arms moved at eye level from left to right and back again. These eye calisthenics were supposed to relieve my years of back pain. Yeah, right, I remember thinking that Sunday morning 18 months ago as I felt an odd exhaustion set in. Slow and subtle was harder than I thought. I fidgeted. My eyes grew tired. How was all of this commotion under my lids supposed to stop my right hip from unnecessary rotation when I walked and unfreeze my left shoulder and neck? I had tried the Feldenkrais Method under some duress. Although there aren’t a lot of good studies, my friend Jon told me it had reduced his lower back pain from excruciating to manageable. Too many chiropractors, osteopaths, yoga classes, trainers, acupuncturists and ibuprofen over 30 years of back pain. They had at best given me only temporary relief — or sometimes more pain. Feldenkrais sounded too nuanced, with its slow and subtle movements that were supposed to retrain how I walked, sat or held myself as I typed a story on my computer. © 1996-2018 The Washington Post

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25502 - Posted: 09.28.2018

By Nicholas Bakalar Consuming caffeine regularly may increase the ability to withstand pain, a small study suggests. Researchers recruited 62 men and women, ages 19 to 77, and had them record their daily caffeine intake from coffee, tea, soda, energy drinks and chocolate. They averaged 170 milligrams of caffeine a day, about the amount in two cups of coffee, although 15 percent of the group consumed more than 400 milligrams a day. The study is in Psychopharmacology. After seven days, they took the volunteers into a laboratory to test their pain tolerance using calibrated devices that gradually increased heat or pressure on a volunteer’s forearm or back. The people pressed a button on a hand-held device first when the sensation became painful, and then again when it became intolerable. The experiment controlled for sex and race, current tobacco use and alcohol consumption, among other variables that could affect pain sensation. Still, they found that the more caffeine consumed, the greater the tolerance for pain. “Diet can actually be a useful intervention for decreasing pain sensitivity,” said the lead author, Burel R. Goodin, an associate professor of psychology at the University of Alabama at Birmingham. “It’s not just caffeine. A study has shown, for example, that a plant-based diet can actually help increase pain tolerance.” © 2018 The New York Times Company

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25501 - Posted: 09.28.2018

Stephanie O'Neill Shirley Avedon, 90,­­ had never been a cannabis user. But carpal tunnel syndrome that sends shooting pains into both of her hands and an aversion to conventional steroid and surgical treatments is prompting her to consider some new options. "It's very painful, sometimes I can't even open my hand," Avedon says. So for the second time in two months, she's climbed on board a bus that provides seniors at the Laguna Woods Village retirement community in Orange County, Calif., with a free shuttle to a nearby marijuana dispensary. The retired manager of an oncology office says she's seeking the same relief she saw cancer patients get from smoking marijuana 25 years ago. "At that time (marijuana) wasn't legal, so they used to get it off their children," she says with a laugh. "It was fantastic what it did for them." Avedon, who doesn't want to get high from anything she uses, picked up a topical cream on her first trip that was sold as a pain reliever. It contained cannabidiol or CBD, but was formulated without THC, or tetrahydrocannabinol, marijuana's psychoactive ingredient. "It helped a little," she says. "Now I'm going back for the second time hoping they have something better." As more states legalize marijuana for medical or recreational use — 30 states plus the District of Columbia to date — the cannabis industry is booming. Among the fastest growing group of users: people over 50, with especially steep increases among those 65 and older. And some dispensaries are tailoring their pitches to seniors like Avedon who are seeking alternatives treatments for their aches, pains and other medical conditions. © 2018 npr

Related chapters from BN8e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 5: The Sensorimotor System
Link ID: 25458 - Posted: 09.17.2018

By Erin Blakemore Janet Jay is a cyborg. No, she’s not RoboCop or Darth Vader. But she shares a similarity with those characters: Her all-too-human body has been upgraded with a machine. A next-generation implant deep in Jay’s back stimulates her spinal cord, overriding her body’s pain signals to give her some relief from the back pain that has plagued her for years. In an article on Popular Science’s website, Jay writes about her experience with pain and the next-generation way she’s finding relief. She is hardly alone in her suffering. According to the National Center for Health Statistics, an estimated 25.3 million Americans, or 11.2 percent of U.S. adults, experience chronic pain. It can interfere with work and home life and leave patients debilitated, disabled and depressed. So it makes sense that Jay jumped at the chance to experience long-term pain relief with the help of a spinal-cord stimulator. Jay lays out the hows and whys of spinal stimulation, and she paints a vivid picture of a life in agony, a journey that has included skeptical doctors, plenty of painkillers and unanswered questions about the future. She also describes her path to spinal stimulation, how the device works with the body to short-circuit pain, and the many roadblocks to relief that patients face. “Even for me, the battle is not over,” Jay writes. “Since this surgery I’ve actually had another disc herniate, complicating everything. My spine isn’t cured, and I still hurt all the time. But the pain is far more controlled, and I can function much better at my current level of discomfort.” © 1996-2018 The Washington Post

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25455 - Posted: 09.17.2018

Aimee Cunningham Certain brain and personality characteristics may help predict whether a sugar pill can provide relief to someone suffering from chronic pain. In a small study, patients with persistent back pain who responded to a placebo treatment benefitted from up to a 33 percent reduction in their pain intensity. These people had distinctive features in their brains and certain personality traits, researchers report online September 12 in Nature Communications. About 20 percent of U.S. adults, or about 50 million people, had chronic pain in 2016, according to new data released September 13 by the U.S. Centers for Disease Control and Prevention. Chronic pain was defined as feeling pain on most days, if not every day, over the previous six months. Being able to identify people who respond to a placebo might mean doctors could give these individuals the option of a pain reliever that’s cheap, free of side effects and — unlike opioids, which are often prescribed to treat persistent pain — not addictive. “We need to seriously think about placebo as a treatment option, especially in chronic pain patients,” says neuroscientist and study coauthor A. Vania Apkarian of Northwestern University Feinberg School of Medicine in Chicago. |© Society for Science & the Public 2000 - 2018

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25452 - Posted: 09.15.2018

Laurel Hamers A draft of the poppy’s genetic instruction book is providing clues to how the plant evolved to produce molecules such as morphine. Scientists pieced together the genome of the opium poppy (Papaver somniferum). Then, they identified a cluster of 15 close-together genes that help the plant synthesize a group of chemically related compounds that includes powerful painkillers like morphine as well as other molecules with potential medical properties (SN: 6/10/17, p. 22). A group of genes that help poppy plants produce some of these molecules, collectively known as benzylisoquinoline alkaloids, have been clustered together for tens of millions of years, researchers report online August 30 in Science. But the plant’s morphine production evolved more recently. Around 7.8 million years ago, the plant copied its entire genome. Some of the resulting surplus genes evolved new roles helping poppies produce morphine, because the plant already had at least one other copy of those genes carrying out their original jobs. It wasn’t a one-step process, though. An even earlier gene duplication event caused two genes to fuse into one. That hybrid gene is responsible for a key shape-shift in alkaloid precursors, directing those molecules down the chemical pathway toward morphinelike compounds instead of other benzylisoquinoline alkaloids (SN Online: 6/25/15). |© Society for Science & the Public 2000 - 2018.

Related chapters from BN8e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 5: The Sensorimotor System
Link ID: 25399 - Posted: 08.31.2018