Phantom limb pain: peripheral or central origin?

Martin Diers

In a recent paper by Vaso et al. (2014) it was suggested that phantom limb pain is driven primarily by activity generated within the ectopic dorsal root ganglia (DRG) (they wrote for BiM on it here). Ectopic activity is abnormal spontaneous activity generated in neuromas in the residual limb as well as in dorsal root ganglions. The authors reported … [Read more...]

Non-specific chronic back pain and hyperalgesia – A different story told by laser stimulation

Thomas Weiss

Despite our best scientific endeavors, what actually causes the pain in chronic low back pain (CLBP) often remains unclear. Approximately 85 % of chronic back pain patients are classified as having non-specific low back pain [1] because a definitive diagnosis cannot be given. That is, pain cannot be confidently attributed to known pathoanatomical, … [Read more...]

A novel alternative to conventional pain killers?

Christoph Stein

In a recent clinical study we showed for the first time that a large fraction (about one third) of pain relief produced by morphine (the gold standard among pain killers) is mediated by opioid receptors outside the brain. In patients undergoing knee replacement surgery, the blockade of such peripheral opioid receptors by methylnaltrexone (an opioid … [Read more...]

Role of psychosocial factors in the development of multisite pain

Tory Madden

The Journal of Pain recently published a paper that caught our eye for its simple design and clever investigation of the role of psychosocial factors in the development of multisite pain. And if you got stuck on the word development, then you’ll know why we got excited. Previous research into this has been correlational: depression, fear of pain … [Read more...]

Gender and the body language of pain

Ed Keogh

It is now well established that men and women show general differences in how they report and experience pain - women tend to report more pain, with greater severity and frequency than men. Examples are numerous, and range from laboratory-based pain induction studies on healthy adults through to epidemiological and clinical investigations of … [Read more...]

Do psychological therapies improve outcomes for children with chronic pain?

Emma Fisher

It is common for adolescents and children to experience chronic pain (Perquin et al., 2000). There are many negative implications associated with chronic pain such as limited social contact, lost days from school, and higher levels of anxiety and depression (Hunfeld et al., 2002; Logan, Simons, Stein, & Chastain, 2008; Walker, Guite, Duke, … [Read more...]

What to call the amplification of nociceptive signals in the CNS that contribute to widespread pain?

Tory Madden

Clifford Woolf, who some may know as the ‘father of central sensitisation’, recently wrote a commentary to PAIN.[1] It piqued our interest because it was about the use of the term ‘central sensitisation’, and we suspect we know people who’d insist that the term ‘central sensitisation’ should only be used to describe changes at the dorsal horn, and … [Read more...]

Music modulation of pain perception

Christine Dobek

One good thing about music, when it hits you, you feel no pain -Bob Marley Playing music for pain relief isn’t exactly a new idea. Music has been used as a tool to promote physical and mental recovery for centuries, with the ancient Greeks initially describing music as a rational treatment strategy. Music is a highly desirable treatment tool for … [Read more...]

The trigger point strikes … out!

John Quintner

John Quintner and colleagues recently published a controversial review in Rheumatology. We asked him to present their position in blog form. I expect it to stir some intriguing emotions in many of you and we welcome comments and alternative perspectives. In anticipation, and with tongue almost completely in cheek - remember to avoid the ad hominem … [Read more...]

Silencing phantom limb pain by silencing the DRG

Adahan haim

“The surgery was a success and the patient is dead.” This satirical saying sometimes reflects the outlook of patients and their rehabilitation teams when, despite completing a difficult rehabilitation trajectory, a patient is left with unbearable phantom limb pain. The patient mustered up super-human willpower to rehabilitate himself. The … [Read more...]