“A Placebo Conundrum” by Michael Brooks

beyond-imagination-marina-harrisIT SEEMED like a good idea until I saw the electrodes. Dr Luana Colloca’s white coat offered scant reassurance. “Do you mind receiving a series of electric shocks?” she asked.

I could hardly say no – after all, this was why I was here. Colloca’s colleague, Fabrizio Benedetti of the University of Turin in Italy, had invited me to come and experience their placebo research first hand. Colloca strapped an electrode to my forearm and sat me in a reclining chair in front of a computer screen. “Try to relax,” she said.

First, we established my pain scale by determining the mildest current I could feel, and the maximum amount I could bear. Then Colloca told me that, before I got another shock, a red or a green light would appear on the computer screen.

A green light meant I would receive a mild shock. A red light meant the shock would be more severe, like the jolt you get from an electric fence. All I had to do was rate the pain on a scale of 1 to 10, mild to severe. Continue reading “A Placebo Conundrum” by Michael Brooks

Acupuncture: East meets West

AcuA HAIR-THIN needle pricks the skin. What happens next depends on who you ask. A traditional Chinese practitioner will tell you that acupuncture manipulates the body’s vital energy, Qi (pronounced chee), balancing the opposing forces of Yin and Yang. When Yin and Yang are in harmony, Qi flows freely along pathways called meridians and you stay healthy, but when the Qi gets blocked you become ill. Inserting needles into points along a meridian unblocks Qi and restores the body’s healthy balance.

Western scientists explain it differently. They say inserting needles at acupuncture points stimulates the nervous system to release morphine-like substances that block pain signals. It may also trigger neurotransmitters and neurohormones, which influence such dynamic systems as circulation and the immune response.

Ever since acupuncture caught on in the West, we’ve been seeking to replace the Eastern mysticism with hard facts. But clinical trials so far have produced a disappointingly mixed bag of results that don’t seem to back up the anecdotal claims for the wonders of acupuncture. There might be a steadily building case for clinical relief of some types of pain and nausea. But the inconclusive studies still outweigh the positive ones. Continue reading Acupuncture: East meets West

Let go of outdated paradigms and stop dwelling on Biomechanical tissue-based models when treating Back Pain.

Mick-ThackerThis was the message from CSP fellow Dr Mick Thacker, director of the ‘Pain: Science and Society’ MSc course at King’s College London.

Giving a keynote lecture, Dr Thacker advised delegates to move away from purely mechanical-based therapies for back pain patients, and become more aware of the role of neuro-immnunology in relation to pain.

“Traditional physiotherapy has based its management of back pain on anatomical, tissue-based principles and biomechanics”, said Dr Thacker. Continue reading Let go of outdated paradigms and stop dwelling on Biomechanical tissue-based models when treating Back Pain.

Medication overuse Headaches

Up to a million people in the UK have completely preventable  severe Headaches caused by taking too many painkillers, doctors have said.

They said some were trapped in a “vicious cycle” of taking pain relief, which then caused even more headaches.

The warning came as part of the National Institute for Health and Clinical Excellence’s (NICE) first guidelines for treating headaches.

NICE is also recommending Acupuncture in some circumstances.

This can end up getting into a vicious cycle where your headache gets worse, so you take more painkillers, so your headache gets worse and this just becomes worse and worse and worse”

Medication overuse headaches” feel the same as other common headaches or migraines.

There is no definitive UK data on the incidence of the condition, but studies in other countries suggest 1-2% of people are affected, while the World Health Organisation says figures closer to 5% have been reported.

While painkillers would be many people’s instant response, they could be making sufferers feel even worse. Continue reading Medication overuse Headaches

Whiplash Injuries & Trigger Points

Persistent muscle pain following whiplash is commonly considered the result of poor psychosocial status, illness behaviour, or failing coping skills. However, there is much evidence that this persistent  pain may be due to neurophysiologic mechanisms involving peripheral and central nerve sensitisation. Myofascial trigger points may play a crucial role in maintaing this sensitisation. Recent research suggests that the chemical environment of myofascial trigger points is an important factor. Several consequences are reviewed when central pain mechanisms and myofascial trigger points are included in the differential diagnosis and in the management of patients with persistent pain following whiplash. Continue reading Whiplash Injuries & Trigger Points

Pain really is “All in the Mind”

Doctors and nurses have known for many years that some people are more sensitive to pain than others. Now brain scans of people experiencing the same painful stimulus have provided the first proof that this is so. But the scans also suggest that how much something hurts really is “all in the mind”.

“We saw a huge variation between responses to the same stimulus,” says project leader Bob Coghill of the Wake Forest University School of Medicine in Winston-Salem, North Carolina. “The message is: trust what patients are telling you.” Continue reading Pain really is “All in the Mind”

Back Pain linked to shrinking Brain

BACK pain has a mysterious link with brain damage. Brain scans have shown that patients with chronic lower back pain have lost grey matter from two brain areas. Scientists are not yet sure whether this is the cause of back pain or the result, but the finding could lead to new drug treatments for backache that target the brain rather than the back or spine.

The discovery was made by Vania Apkarian of Northwestern University in Chicago, when he and his colleagues scanned the brains of 26 patients who had suffered lower back pain for at least a year. Some had damage to their sciatic nerve, which emerges at the base of the spine, while the others had no known injury. The team found that all the patients had lost grey matter in two brain regions known to be important in pain perception. Continue reading Back Pain linked to shrinking Brain