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WebMD 5: What You Need to Know About Pain

An expert answers five basic questions about pain, including why you're really aching and what's ahead for treatment.

3. Is chronic pain different for men and women?

Yes. This is a hot topic right now. What we know is there's a larger percentage of women who experience chronic pain --the data in my clinic is two-thirds women to one-third men. Women are more likely to get certain chronic painful conditions, such as fibromyalgia and irritable bowel syndrome. Some conditions tend to affect men more, such as cluster headaches.

Women are also more sensitive to experimentally evoked pain (pain produced in a laboratory or research study) -- heat, cold, electrical stimuli, pressure. But we have to be careful not to interpret this increase to mean that women are weaker than men because there are genetic, hormonal, and central brain differences in women that we believe may be playing a role.

4. What promising new drugs or treatments are on the horizon?

There are drugs under investigation that modulate [adjust] the immune response in certain autoimmune diseases, like rheumatoid arthritis, that lead to chronic pain. Some of these are showing promise.

Researchers are working on gene therapy approaches to chronic pain, using viruses to turn on and off our own internal chemical plants to release pain-relieving substances. An example of this is when you get a runner's high: You can have gene therapy that turns that on continuously. These are still in the early stages, but they hold promise.

Scientists are investigating different ways of implanting stimulators into our nervous system and into our brain to turn off the signals responsible for pain. I think we're going to be seeing exciting treatments for chronic pain in the future.

5. What do we now know about pain that we didn't a few years ago?

The mind and body are very linked, and research is showing that linkage more and more.

Recently, we developed technology [a type of MRI scan called fMRI, or functional magnetic resonance imaging] that allows us to focus on a specific region of the brain responsible for the perception of pain. We had people think about their chronic pain as being this terrible, horrific experience. Then we asked them to think about it in a calming, soothing, pleasant manner. We found their brain activity went up and went down as a consequence. They could see their brain activity, and over time they would eventually learn how to control a specific area of their brain and their pain.

Even so, we're still predominantly using fMRI as a way of better understanding the brain and its relationship to pain, but it's not yet ready for prime time as a treatment. We're just at the tip of the iceberg in understanding the role of the brain in pain.

Reviewed on December 01, 2011

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