Hey guys! The world of research is an exciting place. Every day, we take another step towards helping people significantly decrease and/or put an end to their pain. The research listed below barely scratches the surface of the amount of research that is being done on pain. I hope you enjoy reading it and that it provides you with a hope for a day when we can be free of chronic pain.

Takeaways:

• Consistent use of proton pump inhibitors (pantoprazole, omeprazole, Prevacid) increases the risk of migraine. These medications are used to decrease acid within the stomach. If you’re struggling with migraines and you take proton pump inhibitors, talk to your doctor about switching to a different medication for stomach acid problems.
• An antidepressant known as duloxetine can be used to effectively decrease chronic orofacial pain and depression.
• Parents who are struggling with mental health conditions can impact the physical and mental health of their children. Chronic pain treatment in pediatrics should include addressing the mental health of the parents.
• Chronic pain impacts a part of the brain known as the hippocampus. This can lead to emotional and memory problems. Future chronic pain treatments may be aimed at parts of the brain like the hippocampus and the medial prefrontal cortex.
• Research is showing that viruses like the flu and Covid-19 can lead to chronic pain conditions. Understanding the causes of chronic pain can help us understand how to prevent chronic pain in the first place.

Use of Acid-Suppression Therapy and Odds of Migraine and Severe Headache in the National Health and Nutrition Examination Survey

• A medication category known as Proton Pump Inhibitors (PPIs) have been shown to increase the risk of migraines
• PPIs are used to reduce acid in the stomach
• A study done on 11,818 US adults showed that those who consistently use PPIs have a 70% increased risk of migraines compared to those who do not use PPIs

Slavin, M., Frankenfeld, C., Guirguis, A., & Seng, E. (2024, April 24). Use of Acid-Suppression Therapy and Odds of Migraine and Severe Headache in the National Health and Nutrition Examination Survey. Neurology Journals. https://www.neurology.org/doi/10.1212/CPJ.0000000000200126 

Duloxetine improves chronic orofacial pain and comorbid depressive symptoms in association with reduction of serotonin transporter protein through upregulation of ubiquitinated serotonin transporter protein

• Chronic orofacial pain (COP) is chronic pain in the facial region without an identifiable medical or dental cause
• Burning mouth syndrome (BMS) and persistent idiopathic facial pain (PIFP) fall into this category. They have been classified as psychological/somatic disorders. They take time to diagnose because other disorders must be ruled out first.
• These disorders can significantly impair a person’s quality of life. It’s estimated that 52% of these patients experience depression.
• The cause of these disorders is unclear but current evidence suggests that it is caused by dysfunction of the peripheral and central nervous systems
• Duloxetine is a medication used to treat both neuropathic pain and depression
• It is a promising treatment option for COP
• A study was done to analyze the association between duloxetine, COP, and depression. Results:
• Duloxetine reduces COP
• Inflammation in the body plays a role in the proteins and neurotransmitters that lead to COP
• There is a protein called SERT in the blood of people with COP. This protein helps regulate serotonin. SERT levels vary in people who have depression compared to people who do not have depression.
• Understanding SERT levels can give us a better understanding of COP, depression, and how the two conditions can be treated.

Nakamura, Marikoa; Yoshimi, Akiraa,b,c; Tokura, Tatsuyac; Kimura, Hiroyukic; Kishi, Shinichic; Miyauchi, Tomoyad; Iwamoto, Kunihiroc; Ito, Mikikoe; Sato-Boku, Aijif; Mouri, Akihirog,h; Nabeshima, Toshitakah,i; Ozaki, Norioc; Noda, Yukihiroa,b,c,i,*. Duloxetine improves chronic orofacial pain and comorbid depressive symptoms in association with reduction of serotonin transporter protein through upregulation of ubiquitinated serotonin transporter protein. PAIN 165(5):p 1177-1186, May 2024. | DOI: 10.1097/j.pain.0000000000003124 

The association between parent mental health and pediatric chronic pain: a systematic review and meta-analysis

• 25% of children and adolescents endorse having some form of chronic pain
• Pediatric chronic pain is difficult to treat, persists into adulthood, increases the risk of additional physical and mental health problems, and transmits across generations
• Parent mental health problems are associated with worse outcomes for children with chronic pain, including poorer responses to psychological treatments
• Poor mental health in parents may be a risk factor for the onset and maintenance of pediatric chronic pain
• Parents of kids with chronic pain often have higher rates of anxiety, depression, and general distress
• This can make it more difficult for both the parent and child to deal with health problems
• The mental health of a parent impacts the mental and physical health of a child
• Parents may also experience stress, worry, and/or guilt over their child’s chronic pain
• This research helps us better understand the development of chronic pain and how treatment strategies should be used to support the family and not just the pediatric patient
• Parent mental health should be addressed in the treatment of pediatric chronic pain

Beveridge, Jaimie K.a,*; Noel, Melaniea,b; Soltani, Sabinea; Neville, Alexandraa; Orr, Serena L.a,b,c,d; Madigan, Sheria,b; Birnie, Kathryn A.a,b,c,e. The association between parent mental health and pediatric chronic pain: a systematic review and meta-analysis. PAIN 165(5):p 997-1012, May 2024. | DOI: 10.1097/j.pain.0000000000003125 

Corticolimbic plasticity in pain: hippocampus joins the party

• The hippocampus is a part of the brain that plays a role in memories and emotions.
• Chronic pain can interfere with how the hippocampus works, causing memory problems and emotional difficulties.
• There is another part of the brain called the medial prefrontal cortex which is involved in decision making and emotions
• Researchers did a study where they looked at how chronic pain affects the connection between the hippocampus and the medial prefrontal cortex (mPFC).
• They found that in animals that have chronic pain, the activity of certain brain cells in the hippocampus decreases and that’s what leads to memory problems
• They also found that when they use special techniques to activate these cells, the pain decreased and memory improved
• When the hippocampus and the medial prefrontal cortex are connected and functioning properly, pain is reduced and memory is improved
• Part of the brain called the basolateral amygdala can make pain worse by blocking this connection
• In the future, this research may be used to allow us to focus chronic pain treatments on these specific parts of the brain

Neugebauer, Volkera,b,c; Kiritoshi, Takakia. Corticolimbic plasticity in pain: hippocampus joins the party. PAIN 165(5):p 965-967, May 2024. | DOI: 10.1097/j.pain.0000000000003101 

A step towards better understanding chronic overlapping pain conditions

• Viruses like flu and covid can make people sick, but they may also play a role in the development of chronic overlapping pain conditions (COPCs)
• COPCs are when there are different types of pain in different parts of the body, along with other symptoms such as fatigue, trouble sleeping, and feeling anxious
• A recent study looked at people who had the flu or covid, as well as people who didn’t have either 
• The study showed that the virus may be triggering COPC symptoms, even in people who were healthy before
• There are theories on why this happens:
• Virus may trigger the immune system to go out of control, attacking the nerves and causing pain
• The stress of being sick can alter your brain and make you more sensitive to pain
• This research can help us figure out how to prevent chronic pain in the future. It is also a reminder to take good care of your health and avoid getting sick in the first place.

Fitzcharles, Mary-Anna,b; Cohen, Steven P.c,d; Häuser, Winfriede. A step towards better understanding chronic overlapping pain conditions. PAIN 165(5):p 970-971, May 2024. | DOI: 10.1097/j.pain.0000000000003129 

Fear and Pain Slow the Brain

• The brain is like a symphony where it has different instruments and rhythms. One rhythm is called the alpha rhythm. This is like the background music of your brain when you’re relaxed and not focusing on anything. It shows how relaxed or active your brain is.
• This alpha rhythm may have something to do with how we perceive pain. People who have chronic pain tend to have slower alpha rhythms than people who do not have chronic pain.
• Researchers have theories on why this is happening:
• The brain is working really hard to deal with the chronic pain
• It’s a sign that a person is more sensitive to pain and more likely to develop chronic pain in the first place
• Researchers studied a group of people who had been dealing with chronic low back pain for at least 6 months.
• They filled out questionnaires about how much they feared moving because of the pain, how intense their pain was, and how it affected their daily life
• The goal was to see if there is a connection between how much someone fears moving and the speed of their alpha rhythm
• The study showed that people who have increased levels of fear surrounding physical activity also have slower alpha waves
• Researchers were able to detect these brain waves by using a tool called magnetoencephalography
• Ideally, this research will lead us in the direction of being able to tailor treatments specifically to each person’s pain sensitivity
• Further research is needed to send us into this direction

Mazaheri, Ali PhDa,b; Furman, Andrew J. PhDc; Seminowicz, David A. PhDd. Fear and pain slow the brain. PAIN 165(5):p 963-964, May 2024. | DOI: 10.1097/j.pain.0000000000003099