|
K. Dean Reeves, M.D. Clinical Associate Professor Physical Medicine and Rehabilitation
Emphasis on Research in Use of Prolotherapy (Also called Regenerative Injection Therapy) ReevesOffice @ gmail.com Office Email DeanReevesMD @ gmail.com Personal email
|
 
|
A summary of a recent talk by a neurophysiologist (Mike Patterson PhD) helps explain what happens in chronic pain. This was given at and Oct 2007 conference at the University of Wisconsin and is greatly summarized. WHY PAIN IS STUBBORN 1. Changes in nerve endings themselves: Nerves that used to be just mechanical (Ie pressure or position sense, telling us what position our body parts are in) become pain transmitting nerve endings instead. This means that just holding an arm up or our body in a certain position will stimulate pain fibers. 2. Changes in muscles: When ligaments and tendons are abnormal, muscles that are connected become sources of pain too. Measuring painful spots in muscle reveals elevation of many of the pain transmitters or substances know to associate with more pain such as bradykinin, serotonin, substance P, CGRP, TNFalpha, interleukins 1b, 6 and 8. 3. Spinal cord changes: These changes are like a football team that loses half its defensive line and cannot protect itself from pain. With chronic pain over time the "defensive" neves that block pain just drop out. This means that pain that is not normally severe can be severe because it is not dampened down by these pain blocking nerve fibers. Mild pain can stimulate nerves in the spinal cord that transmit bad pain to the brain. Note that this pain is bad, so it is absolutely real, but it can be caused without a dangerous or severe cause. Note also that taking chronic narcotics appears to also decrease the number and effectiveness of pain blocking cells in the spinal cord. 4. Brain changes. Areas in the brain that process pain can become active on their own, causing the brain to appreciate pain long after the source of pain has been improved. A great deal of research is going on about these unfavorable changes but this is a very complex area.. The reader should take hope in this and this research is vital to achieve true cure in the most difficult cases of pain. It is important to know that pain control is not a simple as just finding weak ligaments and tendons and strengthening them. Why do I mention all this: To explain why chronic pain responds with more difficulty. Also to indicate why just living with chronic pain and postponing treatment for long periods should be avoided as possible.
|
|
To contact us: General questions --> reevesoffice@gmail.com
Billing related questions --> reevesbilling@gmail.com
Research related questions --> DeanReevesMD@gmail.com
|
