Glia and Chronic Pain
From the November 2009 Scientific American Magazine |
New Culprits in Chronic Pain
Glia are nervous system caretakers whose nurturing can go too far. Taming them holds promise for alleviating pain that current medications cannot ease
By R. Douglas Fields
Helen’s left foot slipped off the clutch on impact, twisting her ankle against the car’s floorboard. It felt like a minor sprain at the time, she recalls, but the pain never subsided. Instead it intensified. Eventually, the slightest touch, even the gentle brush of bed linen, shot electric flames up her leg. “I was in so much pain I could not speak, yet inside I was screaming,” wrote the young Englishwoman in an online journal of the mysterious condition that would torment her for the next three years.
The chronic pain suffered by people like Helen is different from the warning slap of acute pain. Acute pain is the body’s most alarming, intense sensation, whose purpose is to stop us from further injuring ourselves. This type of pain is also called pathological pain because an external cause, such as tissue damage, produces the signals that travel the nervous system to the brain, where they are perceived as pain. But imagine if the gut-wrenching agony of a real injury never stopped, even after the wound healed, or if everyday sensations became excruciating: “I was unable to shower … the water felt like daggers,” Helen remembers. “The vibrations in a car, someone walking across floorboards, people talking, a gentle breeze … would set off the uncontrollable pain. Common painkillers … even morphine had no effect. It was like my mind was playing tricks on me.”…
Where do we go to find physicians who have had even minimal success treating Dejerine-Roussy Syndrome? Following my husband’s stroke, the neurologist suggested we “find someone who’s seen it.” But where? Our lives have been desimated by this event. . . with no relief in sight. Linda
This is a difficult problem in which a stroke damages pathways communicating pain and sensation between a major relay point in the brain (the thalamus) and the cerebral cortex. Glia are certainly involved, but the neural connections are themselves damaged, leading to pain and abnormal sensations. You must work through your neurologist to treat this as every patient is different. I am sorry to hear of your situation and I sincerely hope you can find relief and healing. The brain has a remarkable ability to rewire and accommodate to injury, but it can take a very long time.
So strange to read back in your blog and find this. I was backtracking the NPR story on Einstein’s brain… ended up here reading your previous blog posts and wondering about chronic pain & if there were possibly any connection to the glia. For very specific, personal reasons.
I was recently seen by a neurosurgeon who has been doing some interesting things with real-time brain MRIs and pain response in patients diagnosed with Fibromyalgia – as it seems there might be a connection that is more appropriate to neuroscience than to rheumatology…
I will definitely be keeping an eye on your future work both out of simple curiosity & personally-vested interest.
Thanks for linking this. It’s obvious to me that Scientific American is a periodical I ought to rethink subscribing to if you are a contributor.
Best of luck with your continued research.
Please keep up the blogging efforts!