Category Archives: Chronic Pain

Hormone abnormalities from severe chronic pain

Hormone abnormalities in patients with severe and chronic pain who fail standard treatments. – PubMed – NCBI – Dec 2014

Some patients with severe and chronic pain fail to obtain adequate pain relief with standard pharmacologic treatment agents, including low to moderate dosages of opioids.

Understandably, physicians might not believe patients who claim that a standard opioid dosage is an ineffective treatment. These patients may be severely impaired, nonfunctional, and bedridden or housebound

To help characterize these individuals and develop treatment strategies for them, a serum hormone profile consisting of   Continue reading

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Mast Cell-Mediated Mechanisms of Nociception

Mast Cell-Mediated Mechanisms of Nociception – IJMS | Free Full-Text – November 2015

Mast cells are tissue-resident immune cells that release immuno-modulators, chemo-attractants, vasoactive compounds, neuropeptides and growth factors in response to allergens and pathogens constituting a first line of host defense.

The neuroimmune interface of immune cells modulating synaptic responses has been of increasing interest, and mast cells have been proposed as key players in orchestrating inflammation-associated pain pathobiology due to their proximity to both vasculature and nerve fibers.

Molecular underpinnings of mast cell-mediated pain can be disease-specific.   Continue reading

Neuroinflammation: Underlying Cause of Chronic Pain

Neuroinflammation: Treating the Underlying Cause of Chronic, Severe Pain – Tori Rodriguez, MA, LPC – September 08, 2017

I’m pleased that EDS is known, at least to some doctors, to be so painful that it qualified for Dr. Tenant’s short list of “pathologic conditions that cause the most persistent or constant pain”:

Neuroinflammation due to microglial activation is the underlying cause of severe persistent or constant pain, and unless it is suppressed, no real treatment of the cause of pain can be realized,” Dr Tennant told Clinical Pain Advisor.

“Time has taught us that there is a relatively short list of pathologic conditions that cause the most severe, chronic pain — every pain practitioner should have awareness of these,” he added.   Continue reading

Preoperative Catastrophizing != Postoperative Pain

Preoperative pain catastrophizing and postoperative pain after total knee arthroplasty: a prospective cohort study with one year follow-up – free full-text /PMC4869354/ – BMC Musculoskelet Disord. – May 2016

Conclusions: No associations were found between preoperative pain catastrophizing and pain eight weeks or one year after surgery.

The decrease in PCS-scores challenges evidence regarding the stability of pain catastrophizing. However, larger studies of psychological risk factors for pain after TKA are warranted.

This paper shows us that “catastrophizing” is actually distress from the severity of pain.  Continue reading

Brain Imaging as a ‘Lie Detector’ for Chronic Pain

New Guidelines Discourage Use of Brain Imaging as a ‘Lie Detector’ for Chronic Pain Sep-2017

A task force consisting of researchers from around the world and led by a scientist at the Krembil Research Institute in Toronto has released a set of recommendations that advise against the use of brain imaging as a test for chronic pain.  

“It’s not possible at this point in time to say with any degree of certainty that a person does or does not have chronic pain based on brain imaging,” said Dr. Karen Davis, Head, Division of Brain, Imaging and Behaviour-Systems Neuroscience at the Krembil Research Institute at UHN . 

“The only way to truly know if someone is in pain is if they tell you because pain is subjective and it is a complex experience. No brain scan can do that.” Continue reading

Catastrophizing Not a Factor in Spinal Nociceptive Processing

Pain Catastrophizing is Not Associated With Spinal Nociceptive Processing in People With Chronic Widespread Pain – The Clinical Journal of Pain – September 2017

“…we could find no evidence of a significant relationship between pain catastrophizing and measures of spinal nociceptive processing”

This seems significant in light of the push to blame so much of our chronic pain on catastrophizing. At least this proves that our pain doesn’t originate from catastrophizing.

Pain catastrophizing has been associated with

Continue reading

Temporal Summation (Additive Properties) of Pain

Temporal Summation of Pain” is just a fancy and scientifically specific way of saying that repeated pain is additive: after we’ve been whacked once, another hit in the same spot hurts more; If we get hit there over and over, we start cringing because it hurts more and more.

Evoked Temporal Summation in Cats to Highlight Central Sensitization Related to Osteoarthritis-Associated Chronic Pain: A Preliminary Study – Free full-text PMC4032234 – PLoS One. 2014 May

In cats, osteoarthritis causes significant chronic pain.

Chronicity of pain is associated with changes in the central nervous system related to central sensitization, which have to be quantified.  Continue reading

Filling-In, Spatial Summation, and Radiation of Pain

Filling-In, Spatial Summation, and Radiation of Pain: Evidence for a Neural Population Code in the Nociceptive System – Free full-text PMC2804406 – J Neurophysiol. 2009 Dec

The receptive field organization of nociceptive neurons suggests that noxious information may be encoded by population-based mechanisms.

Electrophysiological evidence of population coding mechanisms has remained limited.

However, psychophysical studies examining interactions between multiple noxious stimuli can provide indirect evidence that neuron population recruitment can contribute to both spatial and intensity-related percepts of pain. Continue reading

What It Means to Have a ‘Sitting Disability’

What It Means for Me to Have a ‘Sitting Disability’

This all sounds so familiar, it makes me realize I also have a ‘Sitting Disability” – I just never thought to identify it as such.

I can’t sit.

Well, I can, but not for very long. When I do, it hurts a lot.

There are many medical reasons why a person has difficulty sitting. Mine is because I have a throbbing pain in the low back (lumbago) and shooting pain down my left leg (sciatica).  Continue reading

“I was holding his hand when he pulled the trigger”

How Chronic Pain Killed My Husband — Pain News Network – September 06, 2017 – By Meredith Lawrence, Guest Columnist

Jay’s next doctor’s appointment was scheduled for March 2, and we knew they were going to decrease his medications again.  

The last thing the doctor said to us will stick with me forever.  He said, “My patient’s quality of life is not worth losing my practice over.”

I want people to understand that when chronic pain runs your life, eventually you just want the pain to stop. 

The night before, he woke me up to tell me it was time.  I knew what that meant, but I tried to be strong for his sake. We talked all night long about what it meant, and how it should be.  It was the saddest, strangest, longest night of my life.

I was holding his hand when he pulled the trigger.

I can’t get this line out of my mind. The great love Meredith and Jay had for each other is evident throughout this exceptional story.