Chronic pain affects approximately 100 million people in the U.S. and costs the country over $600 billion a year in lost wages and productivity. There is hope on the horizon, however, with new chronic pain therapies and treatments that offer cutting-edge gadgets and treatment options for pain management.
Scientists have improved their understanding of how chronic pain works in the brain. They now know that pain isn’t just all in the mind; it’s actually in the brain itself. There are physical changes in the neurotransmitters when pain signals are sent to the brain, and these changes can lead to long-term, chronic pain, even after an injury has healed. This process is called “central sensitization,” says Kwai-Tung Chan, MD, a pain specialist and professor of physical medicine and rehabilitation at Baylor College of Medicine in Houston. Chan notes that:
“If initial pain from an injury is not adequately treated, those pain signals are sent repeatedly — which leads to changes in the central nervous system, making it more and more sensitive. Over time, even the gentlest touch can become very painful.”
Once this happens, a patient has moved from suffering from acute pain to dealing with chronic pain. Chronic pain therapies are more complex than acute pain therapies. For most injuries or acute conditions that are properly treated, pain can be managed successfully with over-the-counter or prescription medications combined with physical therapy. For chronic pain, too much medication can lead to dependence, and physical therapy is not always effective.
Innovative chronic pain therapies may be able to help though.
Regenerative stem cells
This technique uses a patient’s own stem cells to help speed the body’s repair of damaged tissues, specifically in degenerative spinal conditions such as degenerative discs. Healthy stem cells are harvested from the patient and then injected into the affected area. The stem cells cue the body to begin healing in a process that is still being studied. Many patients will feel relief very quickly if the procedure works, with changes visible on an MRI within six to 12 months.
Fitness wearables continue to rise in popularity, so why not adapt something similar for chronic pain therapies? NeuroMetrix is a company that manufactures Quell, a wearable for chronic pain sufferers. The device is wrapped around the user’s calf muscle. It delivers a low-level electrical current that heads straight for the central nervous system. This neurostimulation releases opioids in the brain that can tame pain due to fibromyalgia, diabetic neuropathy, sciatica, and other pain conditions.
When paired with a sleep tracking app, patients can use Quell to monitor how well the device is working. Plans are in the works to sync Quell with Apple’s HealthKit, a one-stop dashboard that tracks health and fitness data from multiple apps. Having everything in one place can give the user a better tool to track pain. From pinpointing potential pain triggers in food and how exercise affects pain, HealthKit is a great way to monitor the effectiveness of not only Quell but also other interventions.
The Sensus Pain Management System, also manufactured by NeuroMetrix, targets pain in the lower legs and feet with a similar system of electrical stimulation that targets non-pain-sensing nerves in the legs. Instead of a one-time signal to the central nervous system, the Sensus session lasts for about 60 minutes and offers pain relief for approximately 30 minutes after each session. Users can start a session as often as they like. This device can be especially effective for those with diabetic nerve pain in the feet and legs.
Intradiscal electrothermoplasty (IDET)
This technique is less invasive that surgery to relieve low back pain, but it is producing positive results. Some low back issues are caused by bulging, herniated, or deteriorating discs in the spine. These discs are fluid-filled, tough-shelled sacs that help cushion the bones of the vertebrae against each other. When they are compromised by wear and tear or injury, they can cause tremendous chronic pain.
Intradiscal electrothermoplasty is a minimally invasive procedure. A thin hollow needle is guided into the annulus (the tough outer shell of a disc), through which a wire is passed until it is touching the inner wall of the annulus. The wire is then heated until it destroys the nerves that are affected by the disc’s deterioration. The annulus is also partially melted. This causes the body to generate new materials to rebuild the annulus. In a study in the journal Spine, as many as 60% of patients reported significant pain relief.
Radiofrequency discal nucleoplasty (coblation nucleoplasty)
This procedure is similar to IDET but is even newer. Instead of a heated wire being passed through the annulus, a special radiofrequency probe breaks the molecular bonds of the gel in the disc. This actually vaporizes some of the gel in the disc, which relieves pressure on the disc itself as well as pressure on the affected nerve roots. Because there is a reduction in the amount of fluid in the disc itself, this technique shows most promise for bulging discs and sciatica.
Cold therapy has been used for a variety of conditions since the time of Hippocrates himself, but it has recently gained traction as another form of chronic pain therapies. Wearing gloves and slippers to protect their extremities, patients enter a cryosauna, where temperatures can reach as low as 250 degrees below zero. When a patient leaves a cryosauna, their blood flow increases to help warm up the body, and this increased blood flow is showing promise for treating chronic pain. Patients with severe chronic pain report relief after five sessions or less.
Cutting-edge advancements in chronic pain therapies will continue to improve this year. Which of the above, if any, have you tried?
Image by Partha S Sahana via Flickr