Stories about: chronic regional pain syndrome

Deconstructing neuropathic pain: Could it give clues to better drugs?

neuropathic pain

Neuropathic pain is chronic pain originating through some malfunction of the nervous system, often triggered by an injury. It causes hypersensitivity to innocuous stimuli and is often extremely debilitating. It doesn’t respond to existing painkillers — even opioids can’t reach it well.

New research in a mouse model, described last week in Cell Reports, deconstructed neuropathic pain and could offer new leads for treating it. The carefully done study showed that two major neuropathic pain symptoms in patients — extreme touch sensitivity and extreme cold sensitivity — operate through separate pathways.

“We think this separation will allow targeted drug-based therapies in the future,” says Michael Costigan, PhD, of the F.M. Kirby Neurobiology Center at Boston Children’s Hospital, who was the study’s senior investigator. “If our results stand experimental scrutiny by others, this will be profoundly important in our overall understanding of neuropathic pain.”

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Overcoming pain by tackling the fear factor

chronic regional pain syndrome
Grace Cahners prior to fear-based therapy (photos: Leigh Cahners)

When 11-year old Grace Cahners broke her foot in July 2015, she received the usual support boot, then casting and several weeks of physical therapy (PT). But instead of getting better, her pain intensified over the course of five months, forcing her to miss the first 54 days of sixth grade. She lost her normally sunny disposition and became crippled by fear.

Grace was diagnosed with complex regional pain syndrome (CRPS), a chronic pain condition in which the brain sends an over-abundance of pain signals to the affected limb. Not a newcomer to pain – Grace was diagnosed with psoriatic arthritis at the age of 13 months – she was using a wheelchair by December.

Leigh Cahners, Grace’s mother, knew that full-day narcotic pain medications and traditional PT would not restore Grace’s ability to walk. “I knew we needed another approach,” she says.

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