If you're living with chronic pain, here's important news. Today's pain specialists have sophisticated new treatments -- from effective drugs to implants and electrical stimulation -- to provide chronic pain relief. There's much that can be done to tame the beast.
These advances have emerged in the past several years, as researchers have gained a greater understanding of chronic pain and how it develops. The origins of chronic pain are all too familiar: sports injuries, back injuries, car accidents -- or health conditions like migraines, diabetes, arthritis, shingles, and cancer.
Dupuytren's contracture is an abnormal thickening and tightening of the normally elastic tissue beneath the skin of the palm and fingers. This tissue is called fascia. The fascia contains strands of fibers, like cords, that run from the palm upward into the fingers. In Dupuytren's contracture, these cords tighten, or contract, causing the fingers to curl forward. In severe cases, it can lead to crippling hand deformities.
At times, however, there is no obvious cause of the chronic pain, no trauma or injury people can point to as a source of their chronic pain problem -- which has been frustrating for both patients and their doctors.
The Roots of Chronic Pain -- and Relief
In past generations, people often heard that chronic pain was "all in their heads," says Rollin M. Gallagher, MD, MPH, director of pain management at the Philadelphia VA Medical Center.
Today's pain specialists understand how the sensation of pain occurs -- how the nervous system, including the spinal cord, interacts with the brain to create that sensation, Gallagher says.
Insights into the neurotransmitter system -- the chemical messengers that pass nerve signals -- have opened the door for important new modes of chronic pain relief, he explains. In recent years, scientists have learned how to manipulate those chemical messengers to change the way they interact with the brain's signals.
That's led to use of antidepressants and other drugs that work with specific brain chemicals that affect emotions, and help with perception of pain. "We now have a whole new host of medications that are very effective" for chronic pain relief, Gallagher tells WebMD.
And with advances in MRI imaging, researchers can clearly demonstrate that the changes are very real in the brain, he says. "We can show exactly where the sensation of pain is occurring in the brain when it is activated by stimuli. We can see the effects of pain on emotion -- and emotion on pain."
There's new understanding, too, of a process called "central sensitization," says Kwai-Tung Chan, MD, a pain specialist and professor of physical medicine and rehabilitation at Baylor College of Medicine in Houston. "If initial pain from an injury is not adequately treated, those pain signals are sent repeatedly -- which leads to changes in the central nervous system, making it more and more sensitive. Over time, even the gentlest touch can become very painful."