More about chronic pain

Information about how pain works

The links on this page are to somewhat more technical articles about the cause and treatment of chronic pain, and current research

See also Managing our chronic pain - information on medications, pain management techniques and coping with pain
Politics of pain relief - arguments for the use of opioid analgesics;
Chronic pain websites to visit for information and support;
Treatment and Research links, for articles about Australian pain research, Myofascial Pain Syndrome, trigger point therapy and Post-traumatic Fibromyalgia.

Pain, the Disease - by Melanie Thernstrom, from the New York Times, Dec 16 2001, includes an overview of the latest research and an explanation of neuropathic pain . "... chronic pain resembles a disease, a pathology of the nervous system that produces abnormal changes in the brain and spinal cord."  You need to register with NYT to read the article, but it's free.

Pain Management - Keep It In Your Office - by Dr Hans Hansen.  "As spinal windup teaches us, what once was normal sensation might be transformed into painful allodynia through the plasticity of the central nervous system. Our observation, the physician devoid of pain, does little to validate the patient's complaints. To best understand the pain and the influence on an individual's life requires a patient's self-reporting, the most reliable tool in medicine." Includes the doctor's comments on the usefulness of various types and brands of medications.

Chronic Pain 1: A new disease? - Dr Dan Brookoff explains what the latest research reveals about the how and why of chronic pain.  "Chronic pain is not just a prolonged version of acute pain. As pain signals are repeatedly generated, neural pathways undergo physiochemical changes that make them hypersensitive to the pain signals and resistant to antinociceptive input. In a very real sense, the signals can become embedded in the spinal cord, like a painful memory." With diagrams.

Treatment of Nonmalignant Chronic Pain, by Dawn A Marcus MD (University of Pittsburgh Medical Center) - from American Family Physician, March 1 2000. Describes what is known about the cause of chronic pain and options for treatment, including opioids.

An Analgesic role for cannabinoids - by Christopher W Vaughan, Macdonald J Christie from Sydney University (MJA 2000; 173: 270-272) "An endogenous cannabinoid system, with specific receptors and transmitters, has recently been discovered. This discovery has led pharmacologists to explore the potential of synthetic cannabinoids to selectively target chronic pain disorders without producing the side effects associated with cannabis."

Neurology and Chronic Pain   Special edition of Pain Research & Management - Official Journal of the Canadian Pain Society Spring 2000, Volume 5, Number 1

The Scientific Basis for Understanding Pain in Fibromyalgia by Robert Bennett MD, FRCP - "There are several lines of evidence to suggest that the pain experience of fibromyalgia patients is in part the result of disordered sensory processing at a central level."

More Evidence for Physical basis of Fibromyalgia - A recent finding that fibromyalgia patients have abnormally long "pain memory" provides additional evidence for a central nervous system problem as the root of the disorder. About.com

The ABC's Quantum program featured a story on chronic pain research at the Royal North Shore Hospital (Sydney) in Oct 2000. " ... new research shows that if severe pain is not treated effectively, the result can be lasting damage to the nervous system." 

Personal Pain - report from Scientific American on Dr George Uhl's research into a possible genetic basis for pain susceptibility. More articles: And now for the "wuss" gene (Anna Salleh, ABC science news, July 1999) and The Wimp Factor (Kristen Philipkoski, Wired news, July 1999).  All these articles have good links for more information.

Researchers Min Luo and Ping Li have been investigating the role of "silent synapses" -   junctions between nerve cells and nerve fibres in the spinal cord - in chronic pain.  Extract from the Back Letter: "painful events in the body can "turn on" pain circuits in the spinal cord. Unfortunately, these pain pathways do not appear to "turn off" once the painful stimulus ends. They may even continue to transmit pain signals in response to non-noxious stimuli. "

Physical Proof of Chronic Pain - "Fibromyalgia Patients Have Lower Blood Flow in Brain" according to this item from ABCNews.com's Health and Living pages (April '98).

How Methadone Works - "perhaps one of the safest drugs known"; written mainly for those using methadone to treat heroin addiction, this is also useful information for pain patients; by Jocelyn Woods.

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