From new lupus treatments to fibromyalgia brain signatures to large-scale research on what therapies actually reduce pain, 2016 was an exciting year for chronic pain management research.
1. Non-drug approaches work for chronic pain management
Surveys analyze large swaths of data from multiple studies to show more conclusive proof for a given topic. When it comes to chronic pain management, one such review of the research literature found that complementary health approaches were effective for managing chronic pain. The 2016 survey, completed by the National Center for Complementary and Integrative Health (NCCIH) and published in Mayo Clinic Proceedings, reviewed the effectiveness of the most popular therapies, including yoga, tai chi, and acupuncture. In the survey, they reviewed data from over 100 U.S. studies from the past 50 years.
In terms of safety and effectiveness, the most clinically-relevant findings they found were:
- Acupuncture and yoga for back pain
- Acupuncture and tai chi for knee osteoarthritis
- Massage therapy for neck pain
- Relaxation techniques for headaches and migraines
- Relaxation techniques and tai chi for patients with fibromyalgia
As David Shurtleff, Ph.D. and deputy director of the NCCIH notes:
“These data can equip providers and patients with the information they need to have informed conversations regarding nondrug approaches for treatment of specific pain conditions. It’s important that continued research explore how these approaches actually work and whether these findings apply broadly in diverse clinical settings and patient populations.”
2. Researchers uncover genetic and environmental risk factors for chronic pain
In a study from PLOS Medicine, researchers found that both genetic and environmental risk factors may contribute to chronic pain. They found that:
- Genetics may account for up to 38% of the variation in chronic pain susceptibility
- Environmental factors could account for 18.7% of chronic pain variation
Another large takeaway from this study was that there is a correlation between chronic pain and depression. Chronic pain, the researchers suggest, arises based on the confluence of genetics, the environment, and a person’s susceptibility to depression. For future chronic pain management, they note that:
“The answer to these key questions are likely to signpost new directions for therapeutic interventions and highlight the symptoms that are most amenable to treatment, as well as to prevention.”
3. Fibromyalgia has a neural signature
Researchers at the University of Colorado Boulder used functional MRI scans (fMRI) to study brain activity in patients with fibromyalgia. They found a brain signature, or neurological patterns, that could identify fibromyalgia sufferers with a 93% accuracy.
Fibromyalgia affects more than five million people in the U.S., but with it’s lack of a diagnostic tool and a set of symptoms that often matches other chronic pain conditions, it often takes years for a patient to get a correct diagnosis. Those are years where the patient can’t receive the chronic pain management they really need. This new neural signature could become a huge breakthrough for better diagnosing and identifying fibromyalgia sufferers.
Tor Wager, director of the Cognitive and Affective Control Laboratory, notes:
“Though many pain specialists have established clinical procedures for diagnosing fibromyalgia, the clinical label does not explain what is happening neurologically and it does not reflect the full individuality of patients’ suffering. The potential for brain measures like the ones we developed here is that they can tell us something about the particular brain abnormalities that drive an individual’s suffering. That can help us both recognize fibromyalgia for what it is – a disorder of the central nervous system – and treat it more effectively.”
4. Scientists find the placebo spot in the brain
2016 was a year for revealing how pain operates in the brain. In another study, researchers at the Northwestern Medicine and Rehabilitation Institute of Chicago (RIC) found the sections of the brain responsible for the so-called placebo effect.
The placebo effect is often cited in chronic pain management research. It refers to the known ability for fake treatments to result in actual and tangible reductions in pain for the patient. The researchers explain the importance of these findings. Marwan Baliki, research scientists at RIC, notes:
“Given the enormous societal toll of chronic pain, being able to predict placebo responders in a chronic pain population could both help the design of personalized medicine and enhance the success of clinical trials.”
Vania Apkarian, professor of physiology at Feinberg, goes on to explain:
“The new technology will allow physicians to see what part of the brain is activated during an individual’s pain and choose the specific drug to target this spot. It also will provide more evidence-based measurements. Physicians will be able to measure how the patient’s pain region is affected by the drug.”
5. Exercise proven to reduce pain for older adults
More 2016 research hones in on the importance of exercise for chronic pain management. A study from the Hospital for Special Surgery found that participating in a low-impact exercise program could help older patients:
- Decrease pain
- Improve mobility
- Enhance overall quality of life
Theodore Fields, MD, explains the reason behind this research:
“Joints will often stiffen if not used, and muscles will weaken if not exercised. Our bodies are meant to move, and inactivity leads to weakness and stiffness, and joints with arthritis often worsen with inactivity.”
Of the patients who participated in the study:
- 84% reported less pain after participating in the program
- 95% reported less stiffness
- 92% reported less fatigue
- 95% reported that their balance improved
6. Researchers find possible treatment for lupus
Lupus, an autoimmune disease, affects over one million people in the U.S. Unfortunately, the condition is little known and largely misunderstood. Because of that, viable treatments are hard to come by.
A study published in Nature Medicine, however, found a possible lupus treatment. Introducing a natural immune system protein, IL-2, could rebalance the overactive immune system of lupus patients. It has already been used as a drug to boost the immune system in cancer patients. Researchers hope this option could be rolled out in clinical trials shortly.
As Professor Eric Morand, a researcher on the study, notes:
“The real promise of this treatment is that it calms the hyperactive immune system through multiple mechanisms, which is very important as this new therapy may be effective for many patients. As the drug has been on the market for some time for other diseases, it can be rapidly put into formal trials for lupus treatment right away.”
7. Racial disparities exist in opioid prescriptions
Even when it comes to chronic pain management, issues due to race still come into play. A 2016 study from PLOS ONE, found statistical evidence that blacks patients who visited emergency rooms for back or abdominal pain were significantly less likely to receive prescriptions for opioids than white patients who were suffering from the same level of pain. While we at PainDoctor.com are committed to reducing the amount of opioids used for pain patients (you can see our opioid statement here), the fact that there are measurable discrepancies in care due to a patient’s race, or other characteristic, is abhorrent. All patients deserve the same level of care, regardless of any personal characteristics.
As Dr. Singhal, study author, notes that:
“Access to healthcare and pain management decisions should be made without regards to patients’ race-ethnicity. Health care providers need to be sensitized to their inherent biases, so that they can consciously avoid these biases from affecting their practice behavior.”
8. New pain paradox explains clinical trial failures
A natural substance, Substance P, has been tested for chronic pain management over the last 20 years due to its ability to activate pain in the central nervous system. By targeting and suppressing this substance, researchers hoped to reduce pain levels in patients. What they found instead–over and over again–were complete failures in their clinical trials.
New research from Hebei Medical University and the University of Leeds explains why that is: the substance works differently in the central versus peripheral nervous system. In the peripheral nervous system, Substance P actually makes nerve cells less responsive and excitable. Lead researcher Professor Nikita Gamper explains:
“We were really surprised by the results – Substance P is described in the literature as a molecule that gets nerve cells excited and promotes pain. But we’ve discovered a paradox – that in the peripheral nervous system it acts as one of the body’s natural painkillers and actually suppresses pain. This means that when drugs were used in trials to suppress Substance P’s action in the central nervous system, they may have also prevented it from acting as a painkiller in the peripheral system. So, although the drugs looked like they worked in the lab, when they moved to clinical trials, they failed.”
This new understanding could help transform existing chronic pain management research towards more viable treatment options.
9. Scientists find a link between DNA and fibromyalgia symptoms
Scientists at King’s College London have recently discovered a link between alterations in a patient’s DNA and chronic joint pain, a common fibromyalgia symptom. As noted earlier, fibromyalgia is a condition that is difficult to diagnose, and therefore, treat. This modification signature could also help healthcare professionals create a diagnostic tool for fibromyalgia.
Study author Frances Williams notes:
“Fibromyalgia is influenced by genetic factors, but there are many complicated steps between gene and disease. Identifying measurable epigenetic links is a major step forward. In addition, the results will inform future research in fibromyalgia as well as other chronic pain syndromes, such as irritable bowel syndrome.”
Stephen Simpson, the director of research and programs at Arthritis Research UK, also explains:
“There are millions of people in the UK who are living with the pain of fibromyalgia. This really exciting research is an important step forward in our understanding of how epigenetic differences between individuals can influence our likelihood of developing fibromyalgia and chronic widespread musculoskeletal pain. For too long, people with fibromyalgia have struggled to get a diagnosis for their painful symptoms. This research will help pave the way for better understanding, management and treatment of joint pain.”
10. Tune the brain to reduce pain
Finally, scientists at the University of Manchester recently released a study that showed that particular frequencies piped into the brain could help alleviate pain. This short video explains the basis of this discovery.
Read more chronic pain management research
2016 was a year that was rich in research in chronic pain management. For even more chronic pain management research from 2016, check out our posts from earlier this year:
- 6 Surprising New Chronic Pain Research Findings, from the first half of 2016
- New Research Promises Headache Relief
- 4 Exciting Research Breakthroughs For Lupus
- Cells May Remember Pain, New Research Says
- New Study Finds Link Between Chronic Pain And Lack of Sleep
- 6 New Chiropractic Pain Management Research Findings
- What Causes Pain? New Research Weighs In
- 4 Discoveries From Cutting-Edge Research Into Fibromyalgia Treatments
Keep up with all the new research in chronic pain management in our Research posts, or subscribe to the blog today to get pain news and research delivered straight to your inbox!