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New breakthrough to relieve pain

February 19, 2009 12:00:00 AM PST
Long-term use of opiod drugs to control pain is unsafe and in time these medications can become ineffective. Successful control of chronic pain eludes many doctors and patients, now two new breakthroughs appear to show promise. Nothing stops race car driver Mike Roman. What you can't see on the track is that Mike is a victim of MRSA -- a staph infection that ended up taking his leg.

"When the chief of surgery told me they thought they should amputate it, I just wasn't ready. I'm 29, and I just wanted to be that dad that my dad was to me, and I just didn't envision that with one leg," said Mike.

His amputation caused even more pain.

"I woke up with phantom limb pain and I had been through so much, but this was entirely off the scale," said Mike.

When drugs failed, Mike turned to neuromodulation for relief.

"It's very similar to what is done for a pacemaker," said pain specialist, Dr. Christopher Chisholm, Scripps Memorial Hospital.

A small incision is made in the back. Electrodes are implanted in the spine. A remote control allows Mike to basically turn on the electrodes and turn off his pain.

"It's now blocked and instead of that painful sensation you get a tingling sensation," said Dr. Chisholm.

Meanwhile, doctors at the University of Michigan are using the herpes virus to relieve pain.

"When you inject it into the skin, it goes into the sensory neuron that's right next to the spinal cord," said neurologist, Dr. David Fink.

The gene for one of the body's natural painkillers is inserted into the virus. the virus acts as a shuttle. When injected into the skin, it carries the genes directly to nerves. Soon the body produces more painkillers that block pain signals. Gene therapy and neuromodulation are two new ways that may help millions live med-free and pain-free.

"It was the first time that I had hope," said Mike.

It's been a long road and now Mike is able to reach the finish line, without pain.

Web Extra Information: Pain Relief Background

PERSISTENT PAIN:

Chronic pain, according to the American Chronic Pain Association, occurs when a person's pain persists for a month or more beyond the typical recovery period for an injury or illness from a chronic condition. The pain may not occur constantly, but is enough to interfere with daily life. The debilitating condition affects 50 million Americans.

CAUSES:

The most common causes of chronic pain are long-term illness or disease, ongoing conditions and injuries, according to neurology channel.com. Some long-term illnesses that may lead to chronic pain include cancer, fibromyalgia, arthritis and multiple sclerosis. Ear infections, migraines and peripheral neuropathies like carpal tunnel syndrome are some ongoing conditions that may explain a person's chronic pain. Muscle sprains and strains can also lead to chronic pain. Sometimes, pain that won't go away is pointing to damage to the nervous system, whether it's in the central nervous system (the brain, brainstem or spinal cord) or the peripheral nervous system.

Central pain syndrome sometimes occurs in patients who have undergone damage to the central nervous system -- like to the spinal cord -- and may develop years after that damage has occurred. Trigeminal neuralgia is severe pain on one side of the jaw or cheek caused by damage to the trigeminal nerve, and phantom pain occurs in paralyzed patients or in patients who have had a limb amputated.

Often, it's impossible to find a direct cause of chronic pain. Those who suffer from this kind of pain often ask themselves if the pain is "in their head." The Mayo Clinic says a heightened sensitivity to pain can play a part in the condition. People who suffer from chronic pain often have lower-than-normal levels of painkilling endorphins. Even if no cause is found for a person's chronic pain, the condition can and should be treated.

TREATMENT:

For milder cases of chronic pain, over-the-counter pain medications are effective. For more severe cases, opioid medications like Percocet and Vicodin are sometimes recommended. The drugs have been shown to provide effective pain relief, but a 2003 New England Journal of Medicine review article states long-term opioid use can be unsafe and even ineffective for treating chronic pain. For some, antidepressants or seizure drugs may relieve persistent pain. For others, medications to control pain may need to be injected by a doctor or administered via a medication pump. Pumps supply pain medication directly into spinal fluid.

Other therapies used to treat chronic pain include transcutaneous electrical nerve stimulation (TENS), physical therapy, occupational therapy, acupuncture, hypnosis and yoga. A study published in the Annals of Internal Medicine found 12 weeks of yoga benefited adults with chronic low back pain significantly more than exercise or a self care book. Another option is multidisciplinary pain management programs (MPP), which are made by a staff trained to help a patient manage his or her pain using a variety of methods. Professionals at MPPs can include physicians, registered nurses, psychiatrists or psychologists, physical therapists and biofeedback therapists. Options for treatment can include group therapy, occupational therapy, counseling, biofeedback training, nerve blocks and relaxation training.


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