Wednesday, October 27, 2010

Pain is a four - letter word. Unifying Theory of Pain where are you?

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Pain is universal. You might consider it a four-letter word. Science, literature and religion study it. However, pain studies me and my reactions. When you have both physical and mental pain it is hard to define pain. It is more than a stimulation of nociceptors in the peripheral nervous system, or by damage to or malfunction of the peripheral or central nervous systems [as Wikipedia says].

The doctors at the University of Michigan Pain Clinic say I must first be on anti-depressant medication before I can begin their pain management program. However, they fail to realize this is a conundrum. Pain depresses people. I ask how can an anti-depressant reduce pain? Yet, a fascinating study just published by the University of California, San Diego, in Neuroscience and Biobehavioral Review, proposes a new theory that suggests that chronic depression originates from ancient mechanisms used by the body to deal with physical injury, such as pain, tissue repair and convalescent behavior.

If you think in an evolutionary terms this theory makes sense. An adverse life event prompts neurological processes that physically alter the brain. The neurons remodel in a wound-healing mode. When this adaptive response becomes a habit, pathways are rewired. So if physical pain and mental pain [depression] work on the same mechanism the researchers posit that chronic depression maybe be treated with analgesics.

So if the University of Michigan Pain Clinic says you must first be treated for depression they may be not aware that analgesics might be useful to treat depression that arises from dealing with chronic pain.

It is still a conundrum. When it comes to clinical practice science moves so slow. So what should I do? Until there is a unifying theory of pain doctors will continue to treat separate parts of the body when a holistic approach would be best. Unifying theory of pain where are you?

Here's the link to the Neuroscience and Biobehavioral Review online abstract mentioned:

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