Pain is the body’s warning signal alerting us to the fact that something isn’t right. While there are some pains we don’t have to worry about that will subside on their own—a minor bump or scratch for example—there are other pains that will only lead to more problems and could eventualy lead to chronic nerve pain if we ignore them. In addition, a new study suggests that when there is chronic nerve pain, the pain isn’t just felt through our pain-signaling sensory neurons (nerve cells); the neurons that typically signal a light and gentle touch can change their function and actually signal pain as well.
Pain is a symptom, and the key to effectively treating it is to find out what exactly is causing the pain. But in the fast-paced world of medicine today, more often than not, it’s just the pain that gets addressed. Before we delve into the study, let’s review a few things you need to know about chronic pain in general.
Chronic pain is an epidemic. In the U.S., more than 100 million people per year suffer with chronic pain. At the rate that dangerous nonsteroidal anti-inflammatory drugs (NSAIDs) are flying off the shelves and highly addictive narcotics, like opioids, are being prescribed, instead of fixing pain, we seem to just be masking it a few hours at a time. One recent study shows, in many cases, NSAIDs and opioids may not even stop the pain, and narcotics could, in fact, make chronic pain worse!
Chronic pain is real. Don’t let anyone tell you the chronic pain is all in your head. This biopsychosocial pain theory was making the rounds in the ‘80s and ‘90s, and unfortunately has recently resurfaced. Chronic pain has a source, can be objectively measured and can cause physical changes to the brain, which can be seen on high resolution functional MRI.
Chronic pain can be debilitating. People in chronic pain just want to improve their quality of life, but their chronic pain is so debilitating that for some, it changes who they are. Just recently we updated you on a father with debilitating knee pain who just wanted his life back and was able to achieve that without surgery. There are fitness warriors, like Michelle, who struggled with chronic pain following a meniscus surgery. She, too, was finally able to address her pain, without additional surgery, and achieve her dream of finishing the IRONMAN race.
Chronic pain can be deadly. It isn’t just the risk of sudden-death heart attacks from NSAIDs or overdose of narcotics that can be deadly; patients who are in chronic pain from arthritis are 50% more likely to die by suicide. Many studies have shown a the tragic link between suicide and chronic pain.
Chronic pain after surgery is common. Studies show that as many as half of knee-replacement patients may still have chronic pain after surgery. Hip-replacement pain is very common as well. One reason there may still be chronic pain after a joint replacement is because the knee or hip pain may actually be caused by a nerve in the lower back. Studies have also shown that meniscus surgery doesn’t relieve pain any better than a fake surgery. Spinal fusions for back pain have been shown to overload adjacent segments of the spine, leading to more back pain.
It’s understood that the sensory neurons responsible for signaling pain react when we are in pain, but investigators in a new study found that it isn’t just our pain-signaling neurons getting in on the action. Our neurons that sense pleasant, gentle touch change their functionality and also transmit pain signals in the presence of chronic pain. This study discovered that the reason this happens lies in the level of the RNA molecule (microRNA) in our neurons, which drops when there is chronic nerve pain. Since both types of neurons (pain-signaling and touch-signaling) are regulated by this same molecule, this level drop ultimately leads all of these neurons to be hypersensitive to touch.
The upshot? While the study findings are interesting and help us understand why even a gentle touch can be painful when we have chronic nerve pain, the solution isn’t to keep throwing drugs at the pain. If a warning light came on in your car, you wouldn’t just cover it up so you couldn’t see it. You’d find the source of the problem and fix it before it does more costly damage. If pain alerts you that something is wrong, blocking it with painkillers isn’t going to fix the problem. Pay attention to your body’s warning signal and find a doctor who has, preferably, nonsurgical solutions for treating the source.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…