Managing the pain

Will you soon be able to take a pill that can block pain at its source? Quite possibly, according to researchers at the University of Texas Health Center.

Humans produce a substance similar to capsaicin — which makes chili peppers hot — at sites of pain. And blocking the production of this substance can ease pain, the study found.

The results of the study, published in the Journal of Clinical Investigation, could eventually lead to the development of non-addictive painkillers, researchers said.

“This is a major breakthrough in understanding the mechanisms of pain and how to more effectively treat it,” senior investigator Kenneth Hargreaves, chair of the Department of Endodontics at the UT Health Sciences Center, said in a news release.

When working with mice, researchers found that a group of fatty acids called oxidized linoleic acid metabolites (OLAMs) play an important role in the biology of pain.

“These data demonstrate, for the first time, that OLAMs constitute a new family of naturally occurring capsaicin-like agents, and may explain the role of these substances in many pain conditions,” said Hargreaves. “This hypothesis suggests that agents blocking either the production or action of these substances could lead to new therapies and pharmacological interventions for various inflammatory diseases and pain disorders such as arthritis, fibromyalgia and others, including pain associated with cancer.”

The researchers said they have developed two new classes of analgesic drugs that target OLAMs. These drugs could eventually come in the form of a topical agent, an injection, or a pill or liquid. It is hoped that this medication will block pain at its source — unlike opioid narcotics that travel to the brain and affect the central nervous system.

“Nearly everyone will experience persistent pain at some point in their lifetime,” Dr. Hargreaves said. “Our findings are truly exciting because they will offer physicians, dentists and patients more options in prescription pain medications. In addition, they may help circumvent the problem of addiction and dependency to pain medications, and will have the potential to benefit millions of people who suffer from chronic pain every day.”

Feeling the pain

Millions of people suffer from acute or chronic pain. (Acute pain isn’t long lasting and usually goes away as your body heals. Chronic pain, on the other hand, continues for at least six months after your body has healed.) According to the Chronic Pain Association of Canada, over 18 per cent of Canadians suffer from severe chronic pain, and at any given moment, half of all Canadians experience some kind of pain.

Yet many people living with pain do not receive adequate treatment. In fact, the association says that while 70 per cent of cancer patients experience moderate to severe pain during their illness, fewer than half receive adequate pain relief.

Ongoing pain can be devastating, and it affects every aspect of a person’s life. And the costs are not only social. The annual financial cost of chronic pain, including medical expenses and lost income and productivity is estimated to exceed $10 billion.

Easing the pain

There are currently several types of medication available to help provide pain relief. Over-the-counter (OTC) medications include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (Aspirin), naproxen (Aleve) and ibuprofen (Advil, Motrin). Many NSAIDs are also available at prescription doses.

The most powerful pain relievers are narcotics, but these drugs can be highly addictive. Antidepressants and anticonvulsants are other medications sometimes used to help with chronic pain.

Complimentary or alternative treatments that can help to relieve pain include acupuncture (See Acupuncture for back pain), stress reduction and relaxation exercises such as meditation and yoga, herbal medications, physiotherapy, low-impact exercise, chiropractic interventions and massage. (See Physiotherapy: What to Expect)

Sources: Texas Health Science Center in San Antonio, news release, April 26, 2010; MedlinePlus Health News; Chronic Pain Association of Canada;