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A built-in 'off switch' to stop persistent pain
- EA-3167 1y agoAnyone who's experienced or knows someone who has experienced chronic pain appreciates how desperately the world needs a major breakthrough in this arena. Pain management has evolved, there are steady improvements, but unfortunately a lot of people are effectively left behind and the choice becomes a series of profoundly mind-altering drugs... or profoundly mind-altering pain. The way that pain can erode your personality and your life is hard to express quickly in words, but it's both invisible and endlessly corrosive. I certainly hope that this or another path of research leads to a new generation of therapies that don't depend on opioids and are more effective than current alternatives.
- tpmoney 1y agoYup. Treatment these days for chronic and severe pain amounts to your choice of: 1) Ever escalating doses of NSAIDs / acetaminophen and the associated long term health effects of that. 2) Long term opioid management which will leave you treated like a drug seeker by anyone who isn’t your pain doctor and may or may not also require long term escalation and has its own health concerns and complicates your use of other medications. And god help you if you don’t like your pain doctor because changing them is a whole different world of suspicion and poor treatment. 3) Various physical interventions like nerve ablations or back surgery or steroid injections which come with a host of other risks and also tend to be both expensive and temporary.
- noir_lord 1y agoI’d love an alternative to gabapentin while accepting that it is what keeps me functional enough to be functional, it is for me a remarkable treatment except for the side effects.
- empressplay 1y agoIf you can tolerate pregabalin (Lyrica), it's better at masking pain while causing less brain fog
- hackable_sand 1y agoNah. I'm good.
- hackable_sand 1y agoMaybe I should clarify because my previous comment comes across as dismissive. We need societal frameworks for empathy and care. Nothing is ever so easy as just, just, just do this one thing. I see through people who treat me different because of my pain.
- petesergeant 1y agoFingers crossed for suzetrigine
- vjvjvjvjghv 1y agoThe company I work at does spinal cord stimulation for chronic pain patients. The stories of the patients are just gut wrenching. Chronic pain is just horrible and very hard to understand and treat.
- mhb 1y ago"The current work started when Nitsan Goldstein, who was a graduate student in Betley’s lab at the time, found that other urgent survival needs such as thirst and fear can also reduce enduring pain. That finding supported behavioral models developed in collaboration with the Kennedy lab at Scripps, suggest filtering of sensory input at the parabrachial nucleus can block out long-lasting pain when other more acute needs exist. “That told us the brain must have a built-in way of prioritizing urgent survival needs over pain, and we wanted to find the neurons responsible for that switch,” says Goldstein."
- supportengineer 1y agoI suffer from frequent headaches, as one way to deal with it I sometimes try to find something that will cause me a different type of discomfort, such as walking several miles. Usually works, eventually.
- farrelle25 1y agoThat's interesting about walking. I've done longish walking pilgrimages lasting several weeks (Camino etc.) and some stomach problems and joint problems improved a lot. I usually walked about 25km a day - I realise that's longer walking than what you mentioned. There are some books about walking putting illness into remission. A famous one is "The Salt Path" where someone with "corticobasal degeneration" brain disease was positively impacted by their walk. (Although the claims are in doubt now because the main author wasn't truthful about other aspects of their walk) Anyway walking probably a real positive overall!
- aspenmayer 1y agoI wonder if more light exposure during walking is also a factor? Many folks don’t get enough vitamin D, and light therapy for SAD and other conditions has shown promise as well. I’ve also noticed that 25km+ of daily backpacking for a few weeks continuously helped my overall fitness and wellness, though I don’t have any chronic conditions or ailments at all to speak of. I do question whether many folks would invest the time and effort to do the work, even if they desire the benefits of the exertion.
- delichon 1y agoI'd like to give an off switch for pain to every adult. Here you go, just turn it off if you need to. But if someone gave one to me I'd be in trouble, if not dead. When my back pain got severe I may well have killed the messenger, ignored the pain, and not have made the lifestyle changes that eventually gave me relief by fixing the problem. People with congenital insensitivity to pain usually have multiple damaged joints by adolescence. It's not very enviable.
- SadTrombone 1y agoAs someone with back pain, what were the lifestyle changes?
- maccard 1y agoLower or upper? Lower: lose weight, get moving, strengthen hips, glutes and calves. Upper: lose weight, get moving, strengthen chest, lats, core
- matt_heimer 1y agoCore should be included in lower as well.
- SoftTalker 1y agoStrong core is fundamental.
- maccard 1y agoI don’t disagree but IME, I got 100x the return from glute work (stabilising my hips) than I did from core work.
- __turbobrew__ 1y agoWeak glutes are a common symptom from sitting too much and then other muscles around the hips compensate which causes multiple issues with hip tilt and gait.
- ElijahLynn 1y agoPain Brain Film (dot com) "A documentary that follows the largest fMRI randomized controlled trial challenging conventional wisdom about chronic pain, and revolutionizing treatment for millions." Explains how these neurons get wired to fire when there is no physical stimulus causing the pain. Similar to phantom limb syndrome. There's a book called The Way Out, which documents the technique used in the study featured in the Pain Brain Film above. I can fully attest to this technique. It 100% works. I had chronic neck and back pain for 20 years. I thought it was my desk, I thought it was my posture, thought it was my chair. Nope, it was my mind.
- mhb 1y agoCan't throw us a bone and give a hint what it is? Also, there's no reason not to put the actual link. Unless that's also your email.
- andrewmcwatters 1y agoPain reprocessing therapy
- Paracompact 1y ago> The drive to look deeper into these neurons grew out of a simple observation Betley and his team made shortly after he joined Penn in 2015—hunger could dampen long-term pain responses. “When it came to chronic, lingering pain, hunger seemed to be more powerful than Advil at reducing pain.” This in itself is a very interesting observation. I've always been inclined to fast during times of pain and anxiety, and honestly it kind of works? Could well be part of meditative fasting's popularity throughout history.
- deleted 1y ago[deleted]
- chubot 1y agoYeah I fasted for the first time last year, and it pretty much immediately turned off a pain response due to an overactive immune response I got the idea from a book, and it worked When I ate again, it came back, but I was definitely relieved of pain for awhile. Thankfully the whole episode subsided after about 6 weeks, but it was comforting to know that I could turn it off by fasting.
- DenisM 1y agoHow many hours of not eating does it take to kick in?
- Paracompact 1y agoFor me, it has to be long enough for me to notice the hunger, and then for the hunger to subside. Between that point and lethargy/dizziness is a pretty zen place for me. (Disclaimer: I am not a doctor, and I have no experience with eating disorders.)
- chubot 1y agoI think it was after around 24 hours, and I did almost a 72 hour fast
- m463 1y ago
- cluckindan 1y agoThe question is whether the fire is truly out, or whether the chronic pain is a product of socioeconomics.
- pedalpete 1y agoThis is very interesting, and I think points to the psychosomatic elements of pain, which is probably usually dismissed as "it's all in your head". But really, all pain is "in our head", it just tells us that the pain is elsewhere. The bigger opportunity here may be not to dismiss pain as being in the head, but recognizing that when it is, treating the suspected source is not the best route, or maybe not in isolation.
- jkestner 1y agoI’m currently reading a book, The Way Out by Alan Gordon, on his research into this neuroplastic pain, which is when neural pathways carved by the pain remain after the cause is gone, and how he’s treated it in patients with mental exercises.
- solomonb 1y agoI would be hesitant to turn off some physical pain like that of an injury I don't want to overextend, but for something like a chronic headache this would be a godsend. My most effective treatment for headaches is imitrex but you have to time it correctly and I really hate how it makes my body feel.
- pathartl 1y agoIf areas could be targeted, it could be a massive quality of life improvement for those with endometriosis.
- unit149 1y ago[dead]
- OptionOfT 1y agoI recently got a new hip (at the old age of 36). Due to said age it was VERY hard to find a doctor willing to replace my hip, EVEN THOUGH I had 2 failed repairs, and had to resort to opioids to sleep. And long-term opioid usage (not abuse!) can cause higher the risk of persistent pain after a total hip arthroplasty. Thankfully this is not the case for me. But it was a big concern in this journey.
- freedomben 1y agoWow, you're lucky they even gave you opioids to sleep. Every doctor I know has such bad opio-phobia now that they won't even give them for post-surgery (after you leave the hospital) or broken bones, unless you're at least 50 or 60 years old
- OptionOfT 1y agoI guess I'm lucky the doctor prescribed them to me. I did have a long enough history with him, and showed progress in appointments with hip specialists & PT. But at the end if I can't sleep, I can't do work and I don't make money. Which is even worse. After surgery I came home with a good amount of oxy, which to this date is still in its original packaging. Didn't need it. Oh, and I worked for the consultancy company which essentially caused the opioid crisis, so I was EXTREMELY careful.
- unixhero 1y agoImpinged ahoulder and other shoulder pains --- I have another. Hanging (dead hang) from a pullup bar or staircase. It fixes it. 30 seconds every day, or 3 sets of 30 seconds
- freedomben 1y agohow do you grip the bar for your dead hang? Wide-grip overhand like a normal pull-up? Or narrow-grip underhand like a chin-up, or both, or something else?
- unixhero 1y agoHi! Overhand like a normal pull-up with a standard grip, hands parallel to shoulders if that makes sense.
- freedomben 1y agoYes it does, thank you! Definitely going to trying this out. Shoulder impingement has been a plague on my lifting
- unixhero 1y agoI learnt it from one of those Tiktok Physiotherapist channels. This was some of the benefits I got from Tiktok before I deleted it :)
- mmaunder 1y agoVery interesting. I’ve been battling a herniated disk. It’s the most pain I’ve ever been in. Debilitating. Stuart McGill’s “Back Mechanic” is an illuminating read. The “big 3” exercises have become my staple and they seem to mask the pain long before the underlying injury heals, which takes about a year. So the ideas in this article resonate with me. In particular pain itself becoming self perpetuating, and mechanisms to block pain like hunger. My issue is temporary, but it’s introduced me to the reality that some have been handed a lifetime of non negotiable pain. So this is important work.
- alinajaf 1y agoMany of the comments here talk about lifestyle changes, and I think those are key, but there are some, (perhaps rarer) conditions that unfortunately won't be improved. Trigeminal Neuralgia is one of them. The condition is just... pain. Lot's of pain. More pain than anyone should ever have to go through. When I have episodes, I often feel awe that it's even possible for someone to feel such an incredible amount of pain. Challenges in life help to shape you, make you who you are. But I do feel that this particular challenge was one where it would have been nice to have learned the same lessons some other way. I hope sincerely that treatment based on this research can help.
- cmoski 1y agoRemember when you could measure pain on a scale from 0-10? Then you had to change the scale to 0-1,000,000. Oh my. I'm so glad that's behind me and so much compassion for those that experience it.
- monster_truck 1y agoI've had cluster headaches my whole life. As a kid I would describe them as "a 40 foot tall giant hammering an ice pick through my skull into my eyeball". Tried a lot for a long time, nothing worked. Sometimes standing in the hottest shower possible until I inexplicably throw up and then feel perfectly fine works, sometimes it doesn't. There's really no understating the pain, it is not "2 dimensional", which is what I would use to describe every other form of pain I have experienced. It has a shape with immense depth and detail. Then I got a pretty severe concussion and I mentioned to my doctor at one of the checkups months afterwards that I haven't had any since, they casually threw out "it's entirely possible you're still experiencing them and you just can't feel them now". Scared the hell out of me, but what're you gonna do? They did eventually come back. If we figure it out in my lifetime I'll be damn impressed. All that said, I wouldn't want to turn pain off. It's important to learn to live with and through it, whatever the source might be, if it cannot be fixed.
- aiiizzz 1y agoThat makes no sense. Why would you consider debilitating pain to be important to live through? What is the gain?
- theturtlemoves 1y agoI also experienced stabbing sensations like that, although not that severe. For me the root cause turned out to be my diet. Fixed the nutritional deficiencies and accidentally discovered food intolerances. Still have some neurological issues but much better now
- instagib 1y agoIt makes me think some of these special breathing exercises can reduce pain for a bit similar to meditation. Include exercise. Fasting as mentioned but it can aggravate other symptoms. Fear inducing scenarios usually reduce pain but it’s short lived. Searching for fear sounds like a terrible idea to calm chronic pain. I keep coming back to cervical disc issues that don’t heal and continue to worsen. Exercise like jogging can worsen things. Lifting, pt stretching, walking, and no improvements. I could take a pill but it wouldn’t let me know my limits and I would definitely overextend myself then probably make things worse at a faster pace. [This research also suggests that behavioral interventions such as exercise, meditation, and cognitive behavioral therapy may influence how these brain circuits fire, just as hunger and fear did in the lab. “We’ve shown that this circuit is flexible, it can be dialed up or down,” he says. “So, the future isn’t just about designing a pill. It’s also about asking how behavior, training, and lifestyle can change the way these neurons encode pain.”]
- olly994 1y agoWith impinged nerves in my neck, arm and rear delt, limited (painful) spinal movement so bad I struggled to walk from one part of the house to the other. My (painful) solution was to get a chiropractor to force movement into my spine and other areas. Pain level 11-10. Slowly thing changed but not enough for my satisfaction. Today I play 2 hours of badminton once a week, train with weights every day and do Dragon Flags to few days a week, go out into the mountains twice a week. Now I'm almost totally pain free and at 67 I can't expect perfection but you never know. By the way this is all done with no medication or painkillers.
- freedomben 1y agoI'm 40 and have gotten to the point where after a workout, the target muscles are sore for sometimes 5 or more days, to the point where I can't really exercise other muscles. I've "pushed through" the pain a couple times and it usually ends up causing either an injury or is otherwise quite counter-productive. May I ask, what do you do for recovery that allows you to lift every day?
- asacrowflies 1y agoOften times you need to up protein intake and lower sugar so muscles heal and rebuild in timely manner
- freedomben 1y agoDefinitely good advice generally! In my case I already consume about 80% body weight in protein per day, and I'm also low carb (<35g per meal, <100g per day), and very rarely intake sugar
- zackmorris 1y agoThis reminds me of an article that I saw 10-20 years ago about delivering small amounts of morphine or another opioid to the spine to stop the transmission of pain as effectively as administering medication to the whole body, using an intrathecal pump: https://en.wikipedia.org/wiki/Intrathecal_pump https://en.wikipedia.org/wiki/Intrathecal_pump Supposedly there are few or no side effects since the dose is small and localized. Kind of a shame that it's not more broadly known or used IMHO, since I've been close with people with chronic pain whose quality of life was greatly impacted.
- mikrotikker 1y agoMy wife has chronic pain from Endo, even after hysterectomy. We think it's in the lining of the abdomen now and the pain looks intense. Cannabis being one of the only things that can take the edge off. I think that many women suffer with this condition but due to the lack of research into it there isn't really anything doctors can do for her, or prescribe her (they've tried many drugs).