UT Researcher Finds Possible Source for Pain Inhibition

UT Researcher Finds Possible Source for Pain Inhibition

A University of Texas at Dallas researcher has discovered a new neurological mechanism that is believed to contribute to a reduction in pain. The discovery of neurologin-2 as a cause of exacerbating chronic pain was made by Dr. Ted Price, associate professor in the School of Behavioral and Brain Sciences.

Neurologin-2 is significant to the research community, as if offers potential new therapeutic directions to investigate, according to Dr. Price.

His research on the topic has recently been published online in Pain, the journal of the International Association for the Study of Pain (IASP).

A UT Dallas press release describes Dr. Price’s work the in the following manner:

The study focused on the body’s inhibitory networks — a series of biochemical reactions that decrease certain neurological activity, like pain. Price said a great deal of previous research in this area has focused on the activity of the neurotransmitter GABA, a chemical released by nerve cells in the brain.

Normally a GABA neurotransmitter acts to inhibit neuronal activity, like pain. But, when pain becomes chronic there is strong evidence that a process called GABAergic plasticity can cause GABA to lose its inhibitory activity, sometimes making the pain even worse.

The source of these excitatory actions in neuronal circuits has been broadly attributed to chloride ions, but Price’s research has found another potential cause of GABAergic plasticity: synaptic adhesion molecules called neuroligin-2.

“From a basic science perspective, we’re really excited about it because it demonstrates that the types of GABAergic plasticity that can occur in the setting of chronic pain are more diverse than we’ve appreciated before,” he said.

Price, who heads the undergraduate research program in neuroscience in the School of Behavioral and Brain Sciences, focuses much of his research on understanding the neuroscience behind pain, particularly chronic pain. He said individuals with chronic pain typically don’t receive the pain-reduction benefits delivered by inhibitory systems. Instead, they often experience increased pain.

“When you hit your hand with a hammer, almost everybody has the same reflex reaction — that is, to rub your finger which, in turn, helps to reduce pain. The reason that works is because it increases GABAergic inhibition in the spinal cord,” Price said. “However, people who have chronic pain — if they do the same thing — find that rubbing it actually makes the pain worse. That’s because the GABAergic system loses its efficacy and, in fact, can become excitatory.”

Price said the current research is another step in determining why the GABAergic system stops working correctly in some people; it provides a second theory for what drives the system.

“Having two ideas and different models will allow us to determine what the therapeutic opportunities are — creating something that will change that back to normal. The lack of performance in the inhibitory system is very detrimental to those who are in chronic pain,” he said.

Price said the development of chronic pain is, in essence, one’s body “learning” something that is bad.

“It’s changing the way the body functions — it’s learning. That learning, in the case of chronic pain, is aberrant — it’s causing the situation to get worse. If we can figure out what that form of learning was, then we can potentially reverse it. Understanding that the GABAergic system changes during this form of learning potentially offers a new therapeutic avenue,” he said.

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Authored by: Staff

There are 24 comments for this article
  1. Bob Schubring at 4:33 pm

    Thank you for sharing, Maureen! We’ve got a huge problem in our culture, in understanding psychosomatic pain.

    In plain English, my lower back pain gets a great deal worse, if I suddenly discover that I’ll have to walk three miles because I have a car with a dead battery. That happens because my muscles react to an inquiry from my brain, as to how they can handle a sudden long walk. They respond by increasing muscle tone. Which results in pain.

    That’s a psychosomatic pain. It’s how they happen.

    In our culture, saying the phrase “psychosomatic pain”, is taken by bullies as a bullying license. The bully assumes that by terrorizing me into running, he has overcome my pain.

    What actually happens in that fight-or-flight response, is that I ignore the pain, take off running, inflict further damage to myself, then come away even more exhausted than I had been.

    What’s curious about this, is that culturally, we criticize the opioid pain drugs, in precisely the way we should criticize the bully who makes us overwork and harm ourselves.

    For instance, a common worry about the opioids, is “What if I numb up my pain and then re-injure myself and don’t know it?”. This is actually a valid concern. Opioids have a rare quality in the world of drugs, in that we still feel a little pain and will notice a sudden increase in pain, especially if it occurs elsewhere. This is why one can become accustomed to the effects of Vicodin and safely walk on one’s own, while on it for chronic pain. Take enough of any common surgical general anaesthetic (sodium pentathol, nitrous oxide, etc) to become pain-free and one also becomes unconscious…those drugs are used only in operating rooms, for that reason.

    There certainly is a medical ethics issue, if we administer drugs to someone, to make it easier for that person to obey a bully and harm himself. Doctors should look out for their patients. Not for people seeking to exploit their patients.

    The problem that every pain patient in our culture, needs to overcome, is that there are people in our lives who don’t believe we are sick, and will use any means they can imagine, to force us to do things that cause us harm. Many of the people who mock us, seek to exploit us.

    That fact needs to be made widely known.

    Bullies and exploiters should be ashamed of themselves, for forcing us to get sicker.

    We should not be ashamed of our pain and our ailments.

  2. Maureen at 7:07 am

    Dr. Price’s work does make sense to me… to at least research it!
    I’ve been in daily spine related pain since 1990 after my first fusion and then especially since a traumatic auto accident (not my fault, mind you) that changed my life forever and ever. And, I have been on opioids since. I don’t know what I would do without them.
    I was a nurse of 34 yrs at the point of my accident and love love loved working. Nursing was my passion!
    The day someone plowed into me…my life drastically changed and I became disabled.
    Years later…I’ve been through it all and have become a ‘professional pain person’.
    Four spine surgeries of which the recoveries are very long and tough,
    2 myelograms (OUCH!!! I still have nightmares), many many treatments,
    PT galore, failed spinal stimulator, meds, financial duress etc etc etc later…I fight daily to maintain my pain levels and my sanity.
    Oh yeah, and let’s ‘keep a smile on my face’ 🙂
    (even though I cried myself through yesterday…wicked pain day).

    My recent MRI showed that ‘once again’ my spine is collapsing above and below my fusions and the nerves are even more compromised… I will be seeing a neurosurgeon very soon, just for an opinion. NO more surgery if I can help it!
    The issues never end, as you all know.
    I’ve also become an ‘almost obsessive’ researcher through these years. I do know more than most of the docs I’ve seen about chronic pain. Don’t we all?! 🙂
    I’ve always remained proactive on finding different ways to get through my life as a person living with chronic pain. Even though I have accepted it (years of therapy!)
    I hate hate hate that I’m in pain…and living alone and isolated.

    I have been on Neurontin and then Lyrica and both caused severe s/e!
    Years later I gave Gralise a shot in the dark… have been on Gralise (long acting gabapentin) for about 4 yrs now and without it my nerve pain is off the charts. The 1st year the s/e caused me to go on/off it but I couldn’t live without the relief it gave me and my nerve pain.
    I DESPISE having to take meds, with their s/e etc but it works for me, it at least gets me out of bed and functioning to some degree…everyday is a different day.
    So let’s remember..we are all different in our sufferings, our treatments and our ideas.

    Due to what the CDC and their ‘friends’ are doing to us…
    and although the nerve, muscle and CNS damage has been done and there is nothing I can do about that (I’m also now full of spinal arthritis and scar tissue)…
    I have been on a new journey with Reiki, yoga, a therapist etc to once again explore the possibility of ‘any reasons’ I may be in this pain of mine.
    Am I holding something emotional or traumatic there?
    Actually…I’ve been here, done this before, and none of it is easy but… I WON’T GIVE UP. Besides, it gives me something to do LOL! Live on….

    So, I do hope that something more comes out of Dr. Price’s research.
    As I said, it makes sense to me and I’m thankful that he is at least trying.
    I remain open minded…
    Good luck Dr. Price.

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  4. John s at 10:19 pm

    Dave and Bob; thanks for a stirring round of informative debate.

    I must admit that my thysoris got quite a workout.

    One thing is sure, we all agree there is a problem and if not fixed there will be a much larger problem.

    Thanks guys,

    John S

  5. Krissy at 8:23 pm

    Dave, thank you for speaking English for us. That made sense 🙂

  6. Dave at 3:27 pm

    Bob- thanks for the acknowledgment- actually i was one of two commentators on the NPS who called for lowering the prevalence of all pain conditions. FYI the IASP in their comments clearly stated they thought it was too ambitious to lower the prevalence of painful conditions- and the 2011 IOM report on pain care in America clearly states they dont believ ein cures for pain- and that pain can only be “managed”. Whats missing from the NPS is clear measurable goals- like lowering pain 5% by 2021 or reducing disparities by 10% by 2021. Clearly the creators of the NPS and DHHS did not wish to be held accountable for specific outcomes.
    Oddly enough, I did mention the neglected role of mitochondria in pain research in my comments to the NPS. And oddly enough I met with Johann Boswinkle who first interpreted the works of Fitz Popp into English. And so we share a common interest in light and mitochondria. Unfortunately, the focus in pain research is on nerves and the immune system- and most researchers dont believe in the energy crises model of pain. Thats why pain research has paid little attention to ATP, macroautophagy, protein quality control mechanisms at the cellular level and regenerative care.
    Dr Jerry Tennant- creator of the biomodulator believes helping cells to regenerate and restore their electromagnetic charge is key to healing- an idea that George Washington Crile proposed decades ago. In quantum neurology they use diodes to improve functioning.As Benjamin Franklin was able to cure a woman with deafness with electricity so long ago- i think there is potential in further exploring bioelectrics and light as it relates to pathology and pain.
    So i hope you will continue your research into light and mitochondria- i think there is considerable potential there to help people in pain.

  7. Bob Schubring at 11:49 am

    Thank you for contributing to the National Pain Strategy. What you showed them is obvious but also easily ignored. The goal of a pain relief strategy is to cause there to exist, LESS pain, than currently exists. That needs to be expressed as the mission statement.

    And apparently, your persistence in making that point, persuaded the drafters to write the strategy document, around that principle.

    Restating it one more time: A strategy has a goal.

    So a national pain strategy should have the goal of making pain less prevalent.

    And now the finished strategy document, directly states, that it’s goal is to make pain less prevalent.

    Good job.

    One has to call people out for their successes on occasion, because that trips the reward mechanism in their brains that induces them to keep up the good work.

    FYI my own research interest is mitochondria and ATP biosynthesis. Musculoskeletal pain usually results from lack of energy to move the muscles…our muscles are an unusual type of engine, that directly converts chemical energy into motion. Unlike the common heat engines that move autos, trains, and ships, our muscles don’t turn foot into heat and then use the heat to push an object. We animals use chemical bonding and debonding to slide muscle fibers along one another…and the heat is a true by-product, not an intermediate product.

    This causes a lot of instincts that one develops from working with heat engines, to confuse one’s thinking about muscle motion.

    For example, if I spin the crankshaft of a lawn mower engine, by hand, it takes a lot of force to start it spinning and very much less force to keep it spinning. Once the bearing surface has unbound and begun rolling, frictional loading is tiny.

    Not so with muscles.

    Relaxing a muscle takes energy.

    Shut off the energy and the muscle becomes stiff. It resists moving, when energy is lacking.

    A paper that appeared in one of the Russian journals about 20 yrs ago suggested something astonishing: Exposing mitochondria to bright light, increased their metabolic output. More ATP is coming from mitochondria when we light them up.

    Experiments have had interesting results. Light therapy boosts metabolic output. The increased metabolic capacity drives several processes to work more smoothly.
    1. Muscles are less stiff.
    2. Muscles hurt less.
    3. Lymph organs (t-cells, etc) do their jobs quicker.
    4. Tissue regeneration is faster (wounds heal faster.).

    When I stumbled across this, I recalled the good fortune I’d had in my student days, as my high school biology teacher was a total geek about evolutionary processes…pointing out in lecture, with great enthusiasm, the structural similarity between mitochondria and chloroplasts in eukaryotes, and the blue-green algae in prokaryotes. Also the structural similarity of chlorophyll and heme (the molecular structures differ only at a single atom…Fe for heme, Mg for chlorophyll). The working theory at the time, was that eukaryotes had ingested mitochondria and/or chloroplasts and used them as an ATP source. Which would make the eukaryotes into sybiotic colonies.

    What caught my attention about phototherapy, was that chloroplasts use light for energy and require it. So if chloroplasts developed where light was abundant, they might use it for other purposes.

    My theory is that one or more catalytic surfaces in the mitochondria, rely on light for activation.

    Well, it’s just a theory.

    The advocacy work I got into doing, because I see people divided and conquered and beaten down, because they are afraid to speak up about their condition.

    Science ought not be confused with religion.

    Scholars aren’t priests.

    Molecules aren’t emotionally offended, if we doubt their existence or presume their presence.

    And I object to the common selling practice, of promoting every new crackpot theory as a “potentially-safe replacement for ‘dangerous’ opioids, which should therefore qualify for a federal handout of funding.”

    Treatments that actually work, should remain accessible to the people on whom they work.

    The alternative is to assert that every person must be viewed as identical to every other person and must receive precisely the same treatments. That’s patently absurd because we differ so greatly from one person to the next.

    In short, learning requires access to the truth. Politics frequently obstructs access to true information while spreading false information.

    NPS represents a big step in the right direction, as it acknowledges the pain problem to be real.

    Thanks for supporting NPS

  8. Dave at 1:42 am

    Bob- i gave specific recommendations- its unfortunate that you failed to understand them. If youre unfamiliar with what lies beyond your paradigm- then nothing is stopping you from exploring more then you currently know. Its a big world full of ideas- and as Helen Keller wrote theres many ways to overcome suffering. .Its unfortunate- but typical- of those who are attached to the biomedical paradigm( and other paradigms) that you dislike being informed about things you failed to learn about. Im not impractical or a complainer just because i dont agree with you. Thats called “othering”. All of society needs to broaden and deepen their understanding of pain- no single paradigm is adequate to meet the needs of people in pain. A syncretistic approach should be supported. Our society needs to drop the egotism and work together to lower the prevalence of pain and the suffering from pain- there is no way medicine can do it alone.
    The focus on hyperspecialization in medicine- well doesnt that lead to doctors being challenged to appreciate and understand what lies outside of their specialties.
    The other day I was learning about siddhi yoga ansd shaktipat to see if they may be of value to those suffering pain.I believe in exploring more and turning over as many stones as possible to find answers for people in pain. And whether its yoga, the microbiome, Finroblast growth factor 21, ultradeep hypnosis, biomagnetic pair, upper cervical chiropractic, meditation on twin hearts, life medicine, incarvillateine- ill keep turning over stones.
    POMR is a very different approach to assessment and is much more comprehensive then typical assessments done for pain- its not rocket science- its just a more sensible approach.Deans and professors who essentially are true believers in biomedicine and treating illnesses instead of people need to be retrained as the biomedical focus has fallen far short of what is needed to help people in pain. So the curriculum needs to include more humanities and less of the oh so sacred biomedical courses-and Deans need to overcome their excessive attachment to the hidden curriculum which is biopolitics writ large. After all the biggest complaint about medical care is lack of listening and lack of respect.
    As my previous comments suggests doctors should check for levels of neurotransmitters before and after trying to intervene in pain care. They also should consider the role that diet plays in pain- as my previous comment suggests.
    And for your information- i happened to obtain a copy of the comments made on the NPS- all 1400 pages. Out of all the comments- I was the only one calling for lowering the prevalence of chronic pain-and if you bothered to compare the draft to the final version of the NPS- youll see they changed the final version to include my recommendation- imagine that.

  9. HAZZY at 1:25 pm

    THEY NEED TO STOP PAWNING OFF THESE STUPID ELECTRONIC STIMULATORS THAT DONT WORK. LEAVE US PEOPLE ALONE SUFFERING WITH CHRONIC PAIN. MOST PEOPLE TAKE THEIR PAIN MEDS RESPONSIBLY, AND YOU HAVE THE CLOWNS THAT DONT AND THEY MAKE BAD FOR US. THE GOVERNMENT NEEDS TO LEAVE PEOPLE WITH CHRONIC PAIN ALONE, AND SNATCH THE PEOPLE THAT SELL IT !!!! MY DOCTOR GIVES ME MY MEDS FOR EXACTLY ONE MONTH, IF I DEVIATE, THAN I SUFFER MORE.

  10. Bob Schubring at 10:03 am

    Thank you for explaining to me that pain care won’t get better any time soon. I agree that humans are dumb. However, I disagree that we can cause improvement by hurling a dictionary full of unfamiliar words at people. There is not one scintilla of a suggestion in your reply, Dave, to say how medical doctors’ thinking processes could be improved. Please devise a means of carrying out the changes you suggest. Merely complaining that all of us humans are inadequate to the task, is not helpful to us.

  11. Dave at 7:49 am

    @ Bob- you use the tools at your disposal- because of the reductionistic, capitalistic physicalism of the day. There is no nomic or moral necessity to einschrankung the possibilities and actualities for people in pain that conventionalists commonly try to get away with. Your argument borders on the ” there is no alternative” fallacy. And there are thousands of treatments for pain that are commonly not used- intrathecal hydrogen, minocycline, oxidized ATP, FODMAP diet, juice fasting, incarvillateine, neural prolotherapy, triterpenes, triptolides, inert gases, H2S2 ,anti-psychotics Even if we were to assume that psychosocial factors like stress and lifestyle are “inessential” the allopathic reductionistic oversimplified and ineffective appraoch to pasin commonly used makes no sense from laboratory medicine. First why would doctors give GABA medicine to people in pain without testing for GABA levels before and after they provide such medications. Furthermore as many molecules are associated with pain why not assess all the bioomolecular excesses and deficiencies related to pain for each individual and intervene accordingly? What about vasoactive intestinal peptide levels. Ll6 over IL10, levels of endogenous opioids? Such lack of curiosity when it comes to helping people in pain serves no legitimate purpose. Medicine doesnt use the theory of constraints or complex adaptive system modelsfor pain.
    The facts are simple- medicine is extremely reductionistic and careless when it comes to helpiing people in pain- it comes from a longstanding prejudice to trat organs and not the people who happened to be attached to those organs. So this mereological inessentialism which stems from a herd instinct from medicine- serves no legiitimate purpose and stands in the way of progress in pain care. Pain care will remain in a quagmire because of irrational and unjustifiable attachment to regresseive allopathic/antipathic paradigm- I guess there is no room for diverse, independent or critical thinming in medical pain care nowadays.
    You talk of immediate solutions- and this borders on the “lets finish the job” fallacy- and didnt the CDC use the same fallacy in promoting their anti-opioid campaign. The truth is people have been suffering pain since the dawn of man. Modern medicine doesnt feel any sense of urgency to dramatically improve pain care. Lupus , fibromyalgia, Lyme disease- remain contested illnesses- as they have for decades. So if you want immediate solutions- go to the selenites running the show- go to the president of the AMA, AAFP, MSSNY and tell them to take pain care seriously-i already know the empty pious asseverations youll hear.
    THE POMR and slow medicine may prove better then antipathic pain medicine. But the real key is not allow ourselves to get attached and continue to use suboptimal prevention, diagnosis and treatments for pain. The use of antipathic medicine to address inflammatory pain or GABA to address a deficincy leads to questions about causation- if someone has too little GABA or is low in endogenous opioids then the question becomes what is the best way to address such- rubiscolin, casomorphins can be obtained in the diet- so is giving an opioid the best answer when you dont know if the person diet is deficient in precursors? How bout GABA- now that could be due to MTHFR, a problem in the microbiome, antinutrients in the diet or low levels of tryptophan, taurine, tyrosine, Vitamin d zinc etc- why would you only think a focus on ills and drugs is the right way to go?
    The reductionistic inessentialism known as modern medical pain care is ill conceived, unnecessary and contradicts basic principles of laboratory medicine. Its time for narcisistic medicince to evolve into something much more effective and sensible then its current form. The force and violence of medical care are a form of social darwinism, capitalism, narcissim that assumes that anyone without a license plate that reads doctor is unqualified to have an opinion about medicine. The rest of society- from medicines viewpoint- is inessential. And just like good communication and cohesiveness is needed in organizations- without the parts of society working cohesively to make pain care better- it is unlikely pain care will get better anytime soon.

  12. Bob Schubring at 9:30 am

    Dave, what specific recommendations do you make, if any?

    People who don’t suffer from pathological narcissism, usually don’t study philosophy. We use the tools we have at our disposal because we know how.

    Kindly demonstrate a successful application of whichever brand of Essentialism you are promoting, to a real-life problem, and explain how it is better than the conventional thinking that the rest of us use.

    We require solutions immediately, you see.

    The reason a lot of us find articles like Dr Price’s work interesting, is that they independently confirm the observations we get from experience (eg GABApentin helps some patients and harms others…Therefore we’d like to know whether to take more of it because it’s helping or stop it because it’s harming, and we have a doctor who’s scared witless of the DEA and won’t give us the drugs we know to work.). It is important to understand that political context: A law court and jury might convict my doctor and force me to suffer severe pain, because that jury does not believe me…and if I have this Price study to wave in front of the jury, showing there to be some rational basis for the symptoms I’m claiming, they may spare my life.

    Political context, in the end, drives a great many of people’s decisions.

    My thoughts are that we needed to end the Drug War 102 years ago. Ending it, is the key to fixing everything else that’s wrong with health care, because it is the justification being applied, to why force must be used against patients, allegedly for our own good.

    Dave, how would you take the force and violence out of the healthcare system?

  13. Jean Price at 7:32 am

    Im trying to figure out if this new discovery supports or discredits the body’s “normal reaction” of pain…as a warning mechanism that tells us something is wrong and needs attention. In chronic pain, for many of us, the something wrong is persistently wrong and can’t be fixed. So our bodies continue to send out a true signal but we can’t need it because we know the scar tissue or the fragments or the degeneration or the inflammation or the pressure on nerves or the joint destruction can’t be fixed! I’ve always wondered if this was more the theology of pain than the “grooves” or channels made that send out a false signal even when the situation is remedied (except for the conditions where there is a massive increase in pain sensitivity on many levels). Will be interested to see where this goes.

    FYI…For several years, there has been a blood test that could (almost?) be looked at as a correlation of pain level to disease for those with RA. Yet, I don’t see people talking about this and I wonder why doctors couldn’t use this test to support the need for pain medication for people with RA. The test results report a level of disease activity, by measuring ten or so different proteins in the blood and then doing a algorithm to come up with a number. As I said, the number is a measurement of disease activity, and I imagine also pain levels and could even be interpreted to assess degree of functioning. It would be great if our researchers came up with a test to show this for other diseases or processes after injuries or surgeries that have pain as a major symptom. If pain could somehow be measured distinctly and accurately, I’d think the issue of medications might be remedied, at least for some. That would be a major development, wouldn’t it!?!

  14. dave at 7:32 am

    Discoveries such as these- and the biomedical model itself is terribly flawed. It assumes something which is not true known as mereological inesssentialism-that you can isolate a single function or molecule or pathway and fix that- and the rest of the body will not be altered. Thats like saying pain has no affect on the person life. Researchers arent required to understand complex adaptive systems- they are stuck on outdated models of physiology and outdated Newtonian physics. They are stuck in a time warp and arent evolving their ways into something that works better for Americans that need much better research for their pain.
    There have been thousands of wonder molecules discovered in relation to pain- few get turned into a drug and the ones that are turned into a drug often have side effects. NSAIDS have some terrible side effects- and cause more deaths then opioids each year. Researchers look for new molecules so that possibly they wbe turned into blockbusters like statins- and look at all the bad press and problems with statins now. So i say this research is the same old foolishness and misdirection that is too costly and has yielded too little benefit to people in pain.
    Biomedical researchers arent required to pay for the consequences of their discoveries, take no notice that coreelation is not causation,arent required to consider alternative research, often leave out important data in their research, assume that all diseases are the same- no matter who happens to be attached to the disease condition, and arent required to consider drug disease interactions. And this isnt to mention all the methodological flaws and statistical fibbing that commonly occurs in biomedical research- so much of the research borders on fraud.
    Sheeple may be fooled into thinking biomedical research will find silver bullets for painful condition- this is naive realism and conventionalism- i say it is a costly failure and its time for a new paradigm to replace the regressive thinking and poor outcomes of biomedical research.

  15. Bob Schubring at 12:26 am

    Glad to hear you’re still curious enough to study, Tracy. Don’t count yourself out just yet. There are ways to apply that BSN to helping people, that don’t require you to be ambulatory.

    For instance, I co-founded a charity called “givepainavoice.org”. What we do, is interact online with pain patients and develop their communication skills. It’s mostly a matter of teaching the art of goal-setting. When we develop a chronic illness, we lack the skills to deal with new challenges that the illness poses, and we have to allow ourselves time to master the new skills to meet those challenges. Being helpless and dependent on someone, while hospitalized, feels pretty confining, but it’s not permanent because we will learn new skills, even if we don’t heal fully. So there’s this emotional disconnect, between the Present (which is pretty bleak) and the Future (which may be less so). People stop surrendering and start working at recovery, as soon as they grasp the fact, that recovery is possible.

    Everybody has bad days.

    A lot of people sicker than me, have entire bad weeks.

    Learning to identify specific needs and set goals of meeting those needs, makes the difference during a bad week, between giving up on living, and resting awhile before soldiering on.

    In a communications context, a big problem for many pain patients is the social stigma associated with some of our meds. We need to recognize that some people are stupid and some others are delusional, and a few are outright malicious. We have to protect ourselves from the malicious people by any means necessary, slowly educate the stupid, and rely on the people in our lives, who are actually reliable. There will always be someone accusing me of not being in enough pain, to be unable to do them a particular favor. That’s just people being rude, acting as if I am their indentured servant and not their friend. Thankfully I’m rid of most of those fair-weather friends!!

    What begins making a real difference in patients’ attitudes, is realizing that people are different. Knowing that some people actually care about us, gives us a reason to return that loyalty in kind. Knowing that a few people are sociopaths and view us as playthings instead of people, is a warning to us, to steer clear of future troubles.

    I’ve babbled on excessively about this and am going to shut up and sign off. Please know that you’re invited to look over our Web site for ideas and inspiration. We’re happy to hear what you have to say…and we’d like to visit with you again. Thanks!

  16. Tracy at 7:33 pm

    You said a mouth full my friend. And how long does it take to put a new Rx on the market. GABA pathway is also to bipolar, so it is not a pain medication per say. My pain is loose SI screws, bilateral with a second surgery 50/50% improvement presumably, and no fusion trilevel in place. My problem started 4 years ago this June from a fall from my bike resulting in AVN of the left hip. Needed a second hip replacement because the doctor placed an inappropriate sized ball, so the hip popped out, I ended up with metalosis and three collapsed vertebrae needing rods, screws and bone harvested, all of which failed AKA failed back surgery syndrome without fusion, so I need another major surgery. I am a liceased nurse unable to work now. So neuronton does not touch my pain because it is not nerve pain. I was an exercise nut and loved to run skate and bike, now I cannot walk. I was 52 years old and have become dependent on pain mgmt. I really don’t want to wait for a theory, GOD has a reason for everything that happens. My anger is being lumped into the same category as the heroin addicts, sorry, instead of sitting feeling sorry for myself I have returned for my BA in nursing, but the $50 thousand dollars education may be worthless if I can’t walk. And less even more if pain controls my thoughts. So you will not win the pain argument with me unless you can empathize. Have a nice night.

  17. Bob Schubring at 3:00 pm

    Pain patients should give ourselves some credit for this discovery.

    The controversial drug Neurontin, now available as generic Gabapentin, is a drug that alters the GABA receptors this paper discusses.

    The controversy, is that some pain patients get a lot better when taking gabapentin, and many other patients get a great deal worse.

    Instead of making up some nonsensical theory or labeling us all as “drug seekers”, this professor, Price, of UT Dallas, went looking for something that might cause some of us to feel better when taking Gabapentin, while causing a lot more of us to get worse from it.

    And he’s identified exactly that. A substance that interacts with GABA in our nerve cells.

    I, for one, want to express my thanks to the University of Texas, for giving Prof Price a place to work on this question. Finding that mechanism was way worse than looking for a needle in a hay stack.

    Now, what else might we discover if we’d quit using labels to insult people, and instead, focus on the fact that sick people don’t like being sick and want to recover somehow?

  18. John S at 11:36 am

    It takes a fatal epedemic to induce new studies and new ideas to help combat chronic pain. Seems like that’s how it works here in America : the HIV virus and cancer come to mind first.

    There will always be the old remedies put into a new box. Just saw a commercial for the external stimulator worn around the calf or leg. Works just like the implanted stimulator ( so they claim ) and boasts an approval rating of 81% of those that tried it. Yes 81 out of 100 people claim their pain was made better after using the $50.00 device. If they sell only a few hundred thousand it will make someone a rich person. It’s a tens unit with new technology.

    I’m tired of the new names for the old modalities the CDC claims is what we really need to treat our pain and if I hear one more Dr say TOOLBOX- referring to their multi pronged treatment to replace medication. It’s when all those modalities are used and still we have severe pain do we need medication that does work.

    I’ve been to my Chiropractor for 7 of the last 9 days. Fifteen years ago I saw my Chiropractor on average or near 3 times a week and when the pain was worse it was 6 times a week. He would use about 4 of the recommended modalities and still the relief was only for a few hours per visit. Then the insurance company stepped in.

    I hope Dr Price is on to something and the Hammer analogy makes perfect sense when you think about it. Ever wonder why a good massage feels great, well Dr Price is taking that reaction to pain much further.

    I believe there is a better way to help pain patients like us. Raise your hand if you enjoy taking a large dose of opiates every day of your life just so you can get dressed. I see only a few hands and that’s the average. Nothing like waking up every morning feeling like crap and the best solution is a pill or pills that the minority wants to keep out of our hands.

    All that aside / we now live in the most advanced times in human history, hell, we parked a boat on Mars and took moving pictures of the planet. That’s why I believe one day soon maybe by mistake, there will be a solution for severe and chronic pain patients. We just need to get through till that happens.

    I know so many of us are scared and worried we will be left with no help – how can millions of people be left to suffer ? They don’t believe there are millions of us and we are just addicts afraid of loosing our monthly meds.
    We need to open our mouths with a pen a letter an email and anything else we can think of. We are doing a poor job of “getting the message out ” We can do a lot better. Guys like Dr Price are trying to help but until the day comes where a better solution is available WE need to be those SOLDIERS that never give up and it seems like we have given up because all we do is complain. Let’s stop complaining and start fighting.

    Thank you Dr Price and good luck.

    Thanks,

    John S

  19. dooney at 8:52 am

    I agree with what you said about the hammer HJ. If I get a paper cut or stub my toe, I’m not screaming in agony requesting morphine at the ER. It hurts for a bit and then goes away. I don’t have any different pain response than anyone else who that might happen to.

  20. Tracy at 8:06 am

    Jill, no I will not hand over and roll over for the CDC. Ever take gabapintin, withdrawals, side effects that interfer with driving, did not touch the pain. And no, this is again government stepping on my right to proper medical care by my doctor.

  21. Sandra at 7:26 am

    Here we go well what are you charging for this. Everybody is jumping on the wagon for people in pain. They all see dollar signs. Makes me sicker ……

  22. HJ at 5:27 am

    The hammer example must be an overly-simplistic representation of the theory. I don’t really relate to that. Either that, or I’m under the delusion that my pain is like “normal” people’s pain (in its qualities and responses)… just, chronic. I think that if I hit my hand with a hammer and rubbed it, I’d probably feel the same relief as a “normal’ person would.

    Not that I intend to go hitting myself with a hammer. The thought did cross my mind, tho. Sigh. Bad idea.

    But of course I want this research to be true. I think the hammer analogy just was a big flop and I think there must be something to this. We need to rush therapeutic treatment testing, because at this rate, they’re going to phase out opiates and we’ll have nothing left but anticonvulsants and anti-depressants, both of which have a slew of side effects and may fail to do the job.

    Right now, my doctor is resisting increasing my tramadol dose. I’ve said I have been having increased pain at night that’s disrupting my sleep. She focuses on SLEEP and offers trazodone. I’m annoyed that she wants to sedate me rather than address my pain. I’d been on trazodone before and told her as much… it makes me groggy during the day and at one point, I was repeating conversations I’d just had… minutes before.

    So, she asks, “What dosage was that? Maybe we can try a lower dose.”

    Please. Just. Not. Trazodone. PAIN. I have PAIN. Not a sleep disorder. I have pain that’s interfering with my sleep, not poor quality sleep that’s increasing my pain. Although if we keep dancing around the problem, I’ll have BOTH problems soon enough.

    We need options. Soon. I’d be glad to stop taking opiates, if something else… WORKED. Until then, both my doctor and I will be tip-toeing and smacking into walls repeatedly.

  23. Jill Jensen at 4:49 am

    This is really good news and provides chronic pain sufferers with true hope for the future!