Category: Centralized pain

Low-impact exercises for pain

Patients struggling with chronic pain find it difficult to engage in exercises. Yet research shows that physical activities is one of the most effective treatments for many pain conditions. It is important for patients to be strategic about exercise, & invest the limited time & energy on sustainable, beneficial forms of exercises. Walking & Nordic walking…

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Gabapentinoids for pain

For chronic pain conditions, gabapentinoids (gabapentin & pregabalin) are often first-line treatments because of their effectiveness & safety. They bind to a2d which alters activity of calcium channels on nerves, thereby modulating pain signals before they reach the brain. Pharmacology of gabapentinoids The absorption of gabapentin & pregabalin differ. Gabapentin absorption is slow. Beyond a…

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Fibromyalgia

Patients with fibromyalgia experience chronic, diffuse pain across the body, due to exquisitely sensitivity of the brain & spinal cord (“central sensitization”). The keys to relief are prompt diagnosis, interdisciplinary pain care, & not overlooking co-existing pain conditions. Total body pain The best way to describe the experience of fibromyalgia is total body pain including a…

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Treating pain at nerve-body interface

Small sensory nerves throughout the body gather information & interact with the body directly. This nerve-body interface underlies many diseases. In chronic pain, nerves cause “neurogenic inflammation” by activating blood vessels, skin, & immune cells. This is the site of action of many pain treatments. Key nerve-body interfaces Neural-vascular: Sensory nerves open blood vessels. This…

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Activating the brainstem to treat pain

Pain signals converge in the core of the brainstem where they deeply influence behavior. For checks & balances, the brainstem uses “descending inhibition” as a volume control to reduce pain. Pain physicians leverage this for treatment, via antidepressants, acupuncture, & meditation. Descending inhibition systems To keep pain signals from running out of control, the brainstem…

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Pain signal networks

Pain signal is sent from tissue to the brain. Once in the brain, the signal causes pain. At each stage of its transmission, pain signals are modified and interact with each other in the “pain signal network”. This network consists of 2 major components, in the body & in the brain. Chronic abdominal pain and…

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