Science continues to uncover brand new ways of alleviating suffering for those living with chronic pain. With awareness about the dangers of opioids growing, identifying these new scientific frontiers has never had more urgency.
While some of the new chronic pain treatments are more predictable—wearable technology, for example—other emerging treatments involve approaches you’d never guess.
Some of the exciting new discoveries are due to researchers’ more complete knowledge about chronic pain pathways and how the condition develops. Chronic pain signals involve the nervous system and complex brain processes, making related research a sophisticated endeavor. However, scientific advances have uncovered many of the biological mechanisms responsible for pain, which has led to new treatments.
1. Wearable technology
Technology is shrinking as it simultaneously becomes more advanced, a trajectory that has resulted in the latest tech development: wearable technology. Chronic pain patients may want to keep an eye on this trend. While a few products have been released, more are sure to come on the market as capabilities expand.
One product available is called Quell. The device consists of an electrode and replaceable battery, and is set inside a wearable sports band that users wrap around their calves. It’s slim enough for clothes to fit comfortably over the top, according the manufacturer.
The electrode provides neurostimulation, a process of nerve signaling that begins in the legs and travels to the brain. Once the signal reaches the brain, it triggers the production of natural opioids that tell the body to stop sending messages of pain. Quell General Manager Frank McGillin says:
“I like to say it’s like a USB port into your central nervous system.”
During each treatment session, patients typically feel a sensation of light pressure or buzzing. The manufacturer says the device automatically calibrates to each person’s body, altering the strength of signals as needed to achieve the most effective relief from chronic pain.
Although each session lasts as long as 60 minutes, users have the ability to turn the device off any time before then. The manufacturer says people may feel relief from pain for up to 60 minutes after the treatment session. The device can be used throughout the day, but it’s best to wait 30 minutes before turning it on again.
The device goes on sale this spring on Quell’s website and will cost $249.
2. Deep brain stimulation
This emerging therapy is a more permanent, dramatic version of the electrodes used in the Quell wearable technology.
With deep brain stimulation, doctors implant electrodes directly into the areas of the brain related to pain processing. A wire connects the electrodes to a pacemaker placed in the chest. The pacemaker then sends electrical currents to the electrodes in the brain, altering the way that part of the brain operates, according to Scientific American.
The pacemaker is programmed to meet each chronic pain patient’s specific needs, including brain chemistry and pain symptoms. Because this therapy is so invasive, it’s only used when no other remedies have worked, according to the University of California, Los Angeles.
The procedure is not Food and Drug Administration (FDA) approved for chronic pain, including headaches, but it’s still an option for qualified patients. However, because it’s not FDA approved, most insurance companies won’t cover it.
Patients experiencing chronic pain from nerve damage may want to investigate cryoneurolysis, a process of freezing nerves to stop pain. The technique involves a small probe cooled to temperatures as low as minus 16 degrees Celsius. When the probe is applied to a pain-causing nerve, the outer layer develops freezer burn. This process disrupts nerve signaling that may diminish or stop pain.
A study conducted by the Society of Interventional Radiology found that 20 patients who underwent the procedure experienced dramatic pain improvement, dropping from a score of eight to 2.4 on a ten-point scale. The most dramatic relief lasted for about two months, until the nerves began to regenerate. However, even after nerve regrowth, patients reported an average pain level of four.
Optimal results with cryoneurolysis likely require repeat treatments, researchers say, although additional studies are needed. The procedure is minimally invasive, with just a small nick required in the skin that’s large enough to insert the IV needle-sized probe.
The same medicines that save people from deadly bacterial infections may also reduce specific types of chronic pain, researchers are discovering.
It’s not a newly uncovered use. Instead, recent studies are connecting some types of back pain with bacterial infections. Most of the infections involved Propionibacterium acnes—the same bacteria that causes acne.
Scientists at the University of Southern Denmark studied patients with herniated discs and found that between 7% and 53% of patients tested positive for bacteria. In patients who underwent back surgery for chronic pain in the back, the link was even stronger, with infections present in nearly 50% of 61 patients tested.
Meanwhile, another study in the European Spine Journal found antibiotics could stop pain for as many as 40% of back pain patients. Because of the bacterial link, researchers are hopeful that more patients can undergo testing for possible infection and receive antibiotics to end or minimize the pain.
However, some experts sounded caution, noting that increased antibiotic usage could have harmful consequences.
Sometimes, chronic pain is caused by damage in a line of nerves known as the sympathetic nerve chain, which runs along the spine from the skull to the tailbone. The nerves impact biological responses including sweating, blushing, and reacting to cold temperatures.
Chronic pain patients who have explored all other options with no relief may consider undergoing surgery to damage this chain of nerves in a procedure known as a sympathectomy, according to Scientific American. The operation interrupts the nerves from signaling pain, but is very serious because it also impacts the other biological responses associated with the nerve chain.
The procedure is drastic, permanent, and controversial, but could be a good option for some patients.
Would you try any of these emerging therapies for chronic pain?
Image by Jean-Etienne Minh-Duy Poirrier via Flickr