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Inflammation and its Role in Disc Degeneration and Neck Pain

Inflammation and its Role in Disc Degeneration and neck pain

Many of the same inflammatory processes involved in Alzheimer's Disease and Diabetes are also involved in disc degeneration.

How does inflammation contribute to the degeneration of spinal discs and the onset of chronic neck pain? By understanding the role that inflammatory processes play in the rupture, collapse, and herniation of discs in the cervical spine we may be better placed to relieve symptoms, slow down degenerative processes and perhaps even help reverse existing damage. Read more

Neck Pain from Heavy Breasts

heavy breasts and neck pain causesAt first glance a 1996 court ruling about breast size might appear to have little to do with neck pain, but the ruling in this case supported the notion that breast reduction surgery is medically necessary to relieve neck pain, headaches, and shoulder pain in some patients. So how do heavy breasts cause neck pain, if at all, and what can you do about it? Read more

The 5 Step Approach to Dealing with Chronic Neck Pain

chronic neck pain managementChronic neck pain can severely reduce quality of life but many patients are only being given palliative treatments, enduring failed surgical interventions, or muddling through with alternative pain therapies of which they’re unsure.

In a forum at PAINWeek 2013, Dr. Ted Jones of the Behavioral Medicine Institute, Knoxville, Tennessee, noted a 5-step strategy for coping with chronic pain that can help patients improve their quality of life by empowering them to change their perceptions of pain. The 5 steps are: Read more

US-Wide Aspirin Recall – Rugby-Label May Contain Acetaminophen

aspirin acetaminophen recall rugby labelTaking aspirin for your neck pain? Make sure to check the contents of that bottle before popping those pain pills. A nationwide recall has been issued in the US after a bottle of 81mg aspirin tablets was found to contain 500mg acetaminophen tablets, putting people at risk of serious liver damage through accidental overdose or drug interactions. Read more

Lifestyle Factors Affecting Neck and Back Pain – Is Neck Pain Inevitable?

new paradigm ahead neck pain not inevitable

Throw away the neck pain paradigm and look at things afresh.

You might think that neck pain and back pain are simply a sad fact of ageing, a natural thing that everyone should expect as they get older. What if neck pain could be cured through healthy lifestyle changes, though? Could a silent epidemic of ill-health induced by environmental toxins, stresses and undernourishment be the true cause of your neck ache, joint pain and stiffness? Read more

Chronic Pain and the Spinal Cord – New Research Reveals Link.

spinal cord and chronic painThose suffering from chronic neck pain may be interested to know that researchers have, for the first time, detailed the involvement of the spinal cord in pain hypersensitivity in humans. Spinal cord involvement has long been suspected in conditions such as fibromyalgia and neck and back pain where no other cause can be pinpointed for the pain but imaging the human spinal cord is somewhat problematic.

Animal research has previously demonstrated the link between spinal cord sensitization and chronic pain but this is the first human trial to show such a link using functional magnetic imaging. The study took place at the Pain Management Division, Stanford University, California, and may offer insights into new ways to treat chronic neck pain and other afflictions. Further tests, this time on patients with fibromyalgia, are planned by the same research team.

The Experience of Pain

The spinal cord receives and transmits nerve impulses throughout the body by way of the nerves that branch out through the neural foramina. Some of these impulses travel all the way from the skin on the fingertips up to the brain and others only to to the spinal cord where some nerve impulse feedback loops occur without signals ever reaching the brain for processing. Patients with fibromyalgia or conditions that affect the spinal cord itself may have overly sensitive reactions to ordinary stimuli, meaning that some find it painful even to wear clothing with zippers and/or have hypersensitive reactions to pain (hyperalgesia).

Fibromyalgia and Pain

A variety of mechanisms have been proposed to explain this oversensitivity in fibromyalgia patients, including small fiber polyneuropathy, abnormally high levels of substance P in the spine, as well as abnormally low levels of serotonin, norepinephrine and dopamine. These neurotransmitters are all involved in pain sensitivity. Fibromyalgia sufferers have also been found to have increased levels of excitatory amino acids in the cerebrospinal fluid (CSF) with an association noted between glutamate and nitric oxide metabolites and clinical assessments of pain.

Research into the Spinal Cord and Chronic Pain

Recognizing that something is likely going on in the spinal cord of patients with chronic pain has led researchers to carry out innumerable animal experiments but these, as with all animal research, have little bearing on human pain and disease and may actually prove to be deceptive and misleading in many cases. This latest research carried out tests on human subjects in order to improve our understanding of chronic pain and spinal cord involvement, using resting-state functional magnetic resonance imaging (MRI) on patients with and without induced central sensitization to pain.


The Spinal Cord and Pain Sensitivity

Presenting the findings of the new study, research assistant Brittney R. Reyes, noted that this work highlights the role of the spinal cord in chronic pain syndromes as being as important as that of the brain. The research team used a capsaicin (hot pepper) cream on the forearm of volunteers in order to block nerve signals transmitting pain to the brain. This was done after an initial application of heat to the area for five minutes, followed by measurements of mechanical pain. The cream remained in place for half an hour and then patients had the heat applied again for five minutes before mechanical hyperalgesia was measured once more.

Mapping the Brain in Pain

A second group had heat applied for 30 seconds to their left forearm, then had 40 seconds without heat and then had the process repeated seven times. No capsaicin cream was used for this group. Both groups had two scans performed, the first to map out the brain’s dorsal horn as the volunteers carried out a task and the second as a baseline for a resting state where the participant simply lay inactive in the MRI scanner.

How the CNS Talks to Itself

The purpose of these scans was to spot any signal fluctuations in the spinal cord and potentially isolate any connections between regions that may indicate a functional relationship. Signals and communication in the spinal cord continues at a low frequency when the participant is not performing a task and the researchers hoped to find which areas of the central nervous system were talking to each other and to what extent after administration of pain and when nerve signals were blocked.

Hypersensitivity to Pain and Spinal Cord Abnormalities

What the researchers found was that the subjects who had not been sensitized to pain had signs of functional connectivity in the C6 area of the spinal cord, while those in the group sensitized to pain had a wider spread of activity in the C6 to C5 regions of the dorsal horn. The results were indicative of activity occurring even when subjects reported having no pain, with ramifications for those with hyperalgesia and allodynia.

Fibromyalgia and Chronic Pain

The research team that carried out this study now intends to test those with fibromyalgia to determine if this increased functional connectivity is present in the spinal cord. Whether this will eventually lead to new treatments for fibromyalgia remains to be seen but these researchers are certainly a step closer to understanding the role of the spinal cord in chronic pain.

American Academy of Pain Medicine (AAPM) 29th Annual Meeting. Abstract 107. Presented April 12, 2013.