Picturing your pain

May 17, 2002

Pain is complex and often frustrating. It usually has a definite cause, like a stubbed toe or an infected tooth but sometimes it can just strike out of the blue. A harmless breeze on the face can send some people into fits of excruciating pain. Others can even be irritated by the clothes on their back. This kind of unexpected and seemingly inexplicable pain is labelled "neuropathic" and occurs due to some sort of malfunction in the nerves. Dr. Catherine Bushnell, McGill University Harold Griffith professor of Anesthesia and Professor of Dentistry and Physiology, explores this mysterious type of pain and how it affects the body.

"Neuropathic pain is the most difficult type of chronic pain to treat," says Dr. Bushnell. It is a very complex type of pain, one that can frustrate researchers as much as patients. Just about the only thing known with certainty is that the origins of this type of pain lie in a malfunctioning nervous system. For some reason, nerve cells either become overstimulated or misfire. This means that an overabundance of pain messages are sent to the brain, causing severe and often long-lasting agony. This condition is often very difficult, if not impossible to treat and can end in long-term disability.

With funding from the Canadian Institutes of Health Research (CIHR), Dr. Bushnell has been looking into the different mechanisms that can cause neuropathic pain and is also investigating treatment options using a variety of medications. Along with investigating pain treatments, Dr. Bushnell is also delving into the psychological aspects of neuropathic pain. "Your psychological state can dramatically alter pain processing. We've found that if somebody is distracted from their pain that they report less pain," says Dr. Bushnell. Using brain imaging, she has been looking into the activity of the brains of patients who are distracted from their pain. Something as simple as drawing less attention to one's pain may end up being even more helpful than many opiates or other pain medications.

An important step in dealing with neuropathic pain, and pain in general, is to catch it early and treat it aggressively. If left untreated, it can end up turning into a chronic condition. "One of the goals of educating patients is to make them understand that blocking pain is a good thing." People often think that they should tough out pain. Actually, studies have shown that such martyrdom sensitizes neurons and makes the pain worse. Blocking pain as soon as possible after its onset reduces the chance of pain in the future. While there are concerns about drug addiction, Dr. Bushnell points out "that treatments are available right now, which if properly used could alleviate a lot of suffering."

Picturing Your Pain
Source: Gaia Remerowski, gremer@po-box.mcgill.ca

Dr. Bushnell is excited about being involved with the proposed McGill Centre for Research on Pain which will boast one of the largest concentrations of internationally known pain researchers in the world. She's enthused about the direction of current pain research. More effective drugs are becoming available and neuropathic pain is being recognized as a legitimate condition. With greater understanding of the link between body and mind, patients in pain will be less likely to hear the frustrating and dismissive comment, "it's all in your mind."

This is the second in a series of interviews with McGill pain researchers whose investigations are funded by the Canadian Institute for Health Research. The project, carried out in cooperation with The McGill Office for Chemistry and Society, aims to highlight recent advances in the study of pain. Permission is granted to reprint in whole or in part.
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McGill University

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