Monthly Archives: May 2009

Covered: Tagged by BikeMonkey

So I got tagged for the “Covered” meme…. Here goes:
Greatest Ever:
Sinead O’Conner, Nothing Compares 2 U, written by Prince, originally performed by The Family.

Worst Ever: Seether, Careless Whisper, destroyed from the original Wham (which is a true classic).

I’m too lazy to tag, but if you’re reading and are so inclined, go for it!

What causes chronic pain – or – how does pain become chronic?

Pain, as terrible as it can be when it outlasts its stay, is actually a vital protective function of our nervous system. The body detects pain through a subgroup of primary sensory neurons, called nociceptors, that innervate the entire body and which normally respond only to high-threshold stimuli such as extreme heat or strong mechanical stimulation. This nociceptive response to potentially tissue damaging stimuli is critical for reflexes and coordinated responses to the stimulus which generally result in a protective reaction (such as withdrawing your hand from a hot stove). Hence, the activation of peripheral nociceptors by pain-inducing stimulation serves a crucial teaching function insofar as it is the signal that protects us from further damage. This fact is best exemplified by studies of rare cases where individuals have a genetic mutation that makes them insensitive to pain. For instance, a family was recently discovered in Pakistan wherein mutations in a voltage-gated sodium channel (called Nav1.7) involved in generating pain signals in nociceptors led to a total lack of pain sensation. Members of this family were working as street entertainers, performing incredible feats such as placing daggers through their arms. Horrifically, one of these young men died after jumping off a roof during one such performance. As tragic as this story is, it serves as an excellent example of how we depend on pain signals to keep us safe from potentially life-threatening injuries. Continue reading

How does a basic researcher improve patient care?

It may seems that the answer is obvious: do high quality research and try to move your work towards the clinic if you are in a position to do so. This is the position that I have taken since I entered the pain neuroscience area back when I was wee PhD student. As of about three weeks ago, I’ve changed my mind.

First, let’s make a few things clear. I still think that ultimately the research has the potential to have the largest impact on patient care. There is a severe lack of efficacious treatment for large swaths of the chronic pain patient population. As we continue to learn more and more about what makes pain become chronic more and more opportunities for intervention arise. Many of these have the potential to be disease modifying, in other words, to reverse chronic pain by targeting its underlying pathophysiology. In the meantime, the more you get involved in patient issues, the more you realize that there are massive numbers of patients that need help right now. I suppose that all of us know this at some level but sometimes events and/or circumstances make it obvious that you need to take another approach. Continue reading

The semester is over!!

Just posted final grades. The semester from hell is over! I may actually blog again sometime soon. Let’s just say that writing several grants, directing a course (as the more or less solo lecturer), teaching 5 hrs a week to med students and getting 4 papers out the door has been stressful. However, I survived!