Hey guys! A lot of new and exciting research has come out. This series of blog posts is meant to remind people that there is always hope because new discoveries are always being made. There are researchers and doctors who have dedicated their lives to understanding and treating chronic pain. Keep learning. Keep searching for answers and hang onto hope!

Local analgesia of electroacupuncture is mediated by the recruitment of neutrophils and released B-endorphins

• Acupuncture has been known to effectively reduce pain and its effects may last for an extended period of time.

• A study found that electroacupuncture applied at specific frequencies to specific body sites can stimulate the release of endogenous opioids (opioids that are naturally produced within the body).

• This study found that electroacupuncture can help reduce pain at the site of inflammation by activating certain nerve fibers and encouraging immune cells with pain-relieving substances to move to that area.

Source:

Shi, Jing-taoa,b; Cao, Wan-yinga; Zhang, Xiao-Ninga; Wan, Hong-Yea; Su, Yang-Shuaia; Qu, Zheng-Yanga; Wang, Ruic; He, Weia; Jing, Xiang-Honga; Wang, Xiao-Yua,*. Local analgesia of electroacupuncture is mediated by the recruitment of neutrophils and released β-endorphins. PAIN 164(9):p 1965-1975, September 2023. | DOI: 10.1097/j.pain.0000000000002892 

Conflicts Hurt: social stress predicts elevated pain and sadness after mild inflammatory increases

• This study was done on 156 postmenopausal breast cancer survivors. Their ages ranged from 36-78 years.

• People can have a psychological response to inflammation and some individuals report more pain, sadness, and fatigue.

• More than ⅓ of middle aged U.S. adults have chronic inflammation

• Some people with inflammation experience no side effects of pain, sadness, or fatigue while others can be more sensitive and impacted by even subthreshold inflammation

• Individual responses to inflammation are impacted by environment, experience, and expectations

• Women are more sensitive to the psychological effects of inflammation

• Participants who reported more frequent social stress were more sensitive to pain and sadness-related effects of increased inflammation. People who are more sensitive to the psychological impacts of inflammaltion are at a higher risk for developing depression.

Source:

Madison, Annelise A.a,b; Renna, Meganc; Andridge, Rebeccad; Peng, Juand; Shrout, M. Rosiee; Sheridan, Johna,f; Lustberg, Maryamg; Ramaswamy, Bhuvaneswarih,i; Wesolowski, Roberth,i; Williams, Nicole O.h,i; Noonan, Anne M.h,i; Reinbolt, Raquel E.h,i; Stover, Daniel G.h,i; Cherian, Mathew A.h,i; Malarkey, William B.h; Kiecolt-Glaser, Janice K.a,j,*. Conflicts hurt: social stress predicts elevated pain and sadness after mild inflammatory increases. PAIN 164(9):p 1985-1994, September 2023. | DOI: 10.1097/j.pain.0000000000002894 

Mediators of the association between childhood trauma and pain sensitivity in adulthood: a multidisciplinary approach to the study of chronic pelvic pain research network analysis

• People with urologic chronic pelvic pain syndrome (UCPPS) often have poor physical and mental health and 38% of these individuals have at least one other chronic pain condition.

• Widespread pain is a common feature of UCPPS which indicates nociplastic pain processes are taking place (the central nervous system is responsible for the pain).

• Physical and sexual abuse during childhood have been linked to heightened pain sensitivity while other forms of trauma and PTSD are also linked with heightened pain sensitivity.

• Chronic pain and PTSD feed off of each other meaning they make each other worse.

• Childhood trauma is associated with affective distress and cognitive dysfunction which are core features of chronic pain.

• This study showed that 1 out of every 5 patients with UCPPS has experienced childhood violent trauma. These traumas during childhood were directly associated with negative health outcomes. Childhood sexual violent trauma was associated w/ higher depressive symptoms, anxiety symptoms, cognitive dysfunction, and generalized sensory sensitivity.

• Childhood nonsexual violent trauma was associated with higher cognitive dysfunction and generalized sensory sensitivity.

• Childhood trauma has the potential to lead to alterations in neurobiological symptoms, immune dysregulation, altered physiological reactivity to stress, and higher rates of mental health disorders.

• The study also showed that traumatic experiences that took place during adulthood can have a stronger impact on current symptoms compared to traumas that took place during childhood.

• Based on this information, people with UCPPS should receive trauma-informed care.

Source:

Pierce, Jennifera,*; Harte, Steven E.a; Afari, Niloofarb; Bradley, Catherine S.c; Griffith, James W.d; Kim, Jayounge; Lutgendorf, Susanf; Naliboff, Bruce D.g; Rodriguez, Larissa V.h; Taple, Bayley J.i; Williams, Davida; Harris, Richard E.a; Schrepf, Andrewa;  on behalf of the MAPP Research Network. Mediators of the association between childhood trauma and pain sensitivity in adulthood: a Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network analysis. PAIN 164(9):p 1995-2008, September 2023. | DOI: 10.1097/j.pain.0000000000002895 

Psychiatric disorders, personality traits, and childhood traumatic events predicting incidence and persistence of chronic pain: results from the CoLaus/ PsyCoLaus study

• Chronic pain leads to emotional distress and a decreased quality of life

• Mental disorders (MDs) are associated with mortality, injuries, and several chronic diseases. MDs play a role in the development, persistence, and treatment of chronic pain. There is a strong link between anxiety, depression, and chronic pain.

• This study analyzed the relationship between neuroticism, extraversion, and chronic pain.

• Neuroticism is a personality trait where a person is naturally inclined towards negative emotions. Extraversion is a personality trait characterized by outgoingness and being able to draw energy from social interactions.

• The study showed that people who score high in neuroticism are more likely to experience chronic pain. Their pain tends to last longer and hurts more.

• The study also showed that people who score high in extraversion are also more likely to develop chronic pain. This may be because extroverts tend to lead riskier lifestyles that put them at risk of experiencing injuries.

• Those who scored low on extraversion (introverts) are more likely to have chronic pain that does not go away. Extroverts tend to have stronger social connections and social connections can help protect against health problems.

Source:

Rouch, Isabellea,b,*; Strippoli, Marie-Pierre F.c; Dorey, Jean-Micheld,e; Ranjbar, Setarehc; Laurent, Bernarda,f; von Gunten, Armine; Preisig, Martinc. Psychiatric disorders, personality traits, and childhood traumatic events predicting incidence and persistence of chronic pain: results from the CoLaus|PsyCoLaus study. PAIN 164(9):p 2084-2092, September 2023. | DOI: 10.1097/j.pain.0000000000002912 

Adjunctive Virtual Reality pain relief after traumatic injury: a proof-of-concept within-person randomized trial

• Virtual reality creates an artificial experience of immersion and presence. There have been an increasing number of studies on virtual reality to determine if it can effectively treat acute and chronic pain. These studies have shown promising results.

• This study was done to evaluate the effectiveness of virtual reality for pain reduction in patients with traumatic brain injuries.

• A lot of people who have had traumatic brain injuries experience chronic headaches and chronic opioid use.

• The study showed that there is a reduction in pain and opioid use in patients who have experienced traumatic brain injuries.

Source:

Morris, Nicholas A.a,b,*; Wang, Yangc; Felix, Ryan B.a,b; Rao, Aniruddhaa,c; Arnold, Shannona,b; Khalid, Mazhara; Armahizer, Michael J.d; Murthi, Sarah B.b,e; Colloca, Luanac. Adjunctive virtual reality pain relief after traumatic injury: a proof-of-concept within-person randomized trial. PAIN 164(9):p 2122-2129, September 2023. | DOI: 10.1097/j.pain.0000000000002914 

Takeaways:

• Acupuncture can reduce pain by causing the body to release it’s own opioids and decreasing inflammation around the pain site.

• People who are experiencing social stress (relationship conflicts, divorce, feeling alone) have more pain and inflammation compared to those who do not have social stress.

• Childhood trauma has negative effects on mental and physical health. People who have chronic pain and childhood trauma should be treated with trauma informed care.

• Virtual reality can reduce pain and opioid use in those with traumatic brain injuries.