Pain

Unlocking The Pain Key

Unlocking The Secrets Of The Sensory Nervous System

Fibromyalgia

Unlocking The Pain Key
First Published: Southern Health News - February 2009
Updated:

Developing a new generation of analgesics that target pain deep within the body is in the long-term sights of neuroscientists at Flinders Medical Centre.

The research team, headed by Professor Simon Brookes from the Flinders Centre for Neuroscience, hopes their work will eventually contribute to the development of targeted pain therapies for a range of conditions including deep muscle pain, heart burn, cystitis and irritable bowel syndrome.

Understanding how nerve endings in the gut wall work is crucial to developing these therapies, according to Simon.

‘Everything we do, everything we learn and everything we respond to is governed by our senses such as touch, smell, taste, sight and hearing,’ Simon said. ‘In practically every medical condition there are changes in sensation; the most obvious one being pain.’

Simon said while sensory nerve cells – the first step in experiencing sensation – were well understood for sensations from the skin, ie. hot and cold detectors, touch and pain detectors, scientists had poor understanding of deep tissue sensory nerves.

Professor Brookes and his colleagues have spent the past decade studying a series of sensory nerve sets within the gut and more recently, the bladder.

‘We have been able to characterise three major sets of sensory neurons in the gut that are responsible for sending information from the gut to the brain and have recently added a fourth set,’ Simon said.

The research team was responsible for discovering the role of nerve endings in the wall of the stomach that were first described more than 70 years ago, but whose function had remained a mystery. They turned out to be the nerves that tell the brain when the stomach is full after a meal.

Discovering these nerves may help identify new targets for drugs which could create better outcomes for a range of conditions, including invoking a sense of fullness sooner in obesity, reducing heartburn episodes or better pain management.

More recently the group identified another type of nerve ending that is involved in signalling pain from the intestines.

‘Most people experience unpleasant sensations from the gastrointestinal tract at some stage in their life, ranging from short-term nausea and vomiting to severe pain. Discovering these nerves may help identify new targets for drugs that could create better outcomes for a wide range of patients,’ Simon said.

Unlocking The Secrets Of The Sensory Nervous System
First Published: Investigator - July 2008
Updated:

Neuroscientists at Flinders Medical Centre have discovered a series of nerves which have changed scientific understanding of how the sensory nervous system works in the gastrointestinal tract.

In 2001 Professor Simon Brookes and his team from the Flinders University Centre for Neuroscience discovered the role of nerve endings in the wall of the stomach that were first described over 70 years ago, but whose function had remained a mystery.

“It seems that these endings tell the brain when the stomach is full and are important in telling us when to stop eating,” said Professor Brookes. “They also play an important role in triggering the reflex that can cause acid reflux and heartburn.”

Since then his group has identified another type of nerve ending that is involved in signalling pain from the intestines.

“For decades it was believed that the pain nerve endings in the gut were only located outside the gut wall and that distension somehow ‘pulled’ on these nerve endings to create sensations of pain in the intestines,” said Professor Brookes.

“We have discovered that there are in fact nerve endings within the wall of the gut, which has changed our understanding of how pain is evoked by many gastrointestinal tract disorders.”

The gastrointestinal tract is the largest organ system in the human body and is responsible for breaking down food to give the body the nutrients it needs for energy, as well as waste disposal.

Many people experience unpleasant sensations from the gastrointestinal tract at some stage in their life, ranging from short-term nausea and vomiting to severe pain.

Discovering these nerves may help identify new targets for drugs which could create better outcomes for a range of conditions, including invoking a sense of fullness sooner in obesity, reducing heartburn episodes or better pain management.

Creating a fuller understanding of the nerve endings in the gut wall may also help researchers understand the mechanisms that underlie pain in other areas of the body, including headache, visceral organ and deep muscle pain.

Fibromyalgia
First Published: Southern Health News - April 2008
Updated:

Fibromyalgia is a chronic pain syndrome. People with the condition may experience widespread pain throughout their muscles and joints and/or super-sensitive ‘tender points.’ Fibromyalgia affects mostly women, between the ages of 35 to 60 years, from all nationalities and culture groups. It can also affect children. There is no cure for fibromyalgia but treatment can help relieve some symptoms.

Cause

No-one knows the exact cause of fibromyalgia, however it is believed to result from an abnormal activation of the central pain system. Put simply, fibromyalgia seems to make the body’s pain perception system oversensitive to pain. The body may even interpret pain from things that would not normally cause pain. In effect, the central nervous system of the body changes its response pattern so that the body interprets even small things as being painful. This is not something that a person has conscious control over. It is the result of internal body mechanisms that are not yet fully understood. Triggers for this activation may include emotional distress, prior physical trauma, severe illness or hereditary factors.

Symptoms

The symptoms of fibromyalgia can vary widely from mild to severe. The most common symptoms include any of the following:

• Fatigue and exhaustion
• Pain – which may present in a variety of ways (such as aching, burning, throbbing or stabbing). The pain may be generalised or in one area.
• Sleep disturbance
• Headaches
• Slowed mental processing
• Stiffness, usually worse in the morning
• Anxiety and depression

The symptoms of fibromyalgia can go up and down. Many people find the symptoms are worse first thing in the morning and last thing at night. The symptoms can be mild, moderate or severe. There may be extended periods of time – perhaps even years – when symptoms disappear. Other people have pain every day, or there may be variations between these two extremes.

Diagnosis

The first step in diagnosing fibromyalgia is a full assessment by a doctor. Blood tests, x-rays and other tests may be used to help exclude other conditions.

There are signs that may suggest a diagnosis of fibromyalgia. These are:

• Abnormal tenderness in specific parts of the body
• A history of widespread pain for three months or longer
• Disturbed sleep patterns.

Treatment

There is no single simple solution for treating fibromyalgia. If you have been diagnosed with fibromyalgia, the management of your condition will largely depend on the severity of your symptoms which may range from very mild and occasional to severe and persistent.

Generally, management will include a combination of the following:

• Education
• Medication
• Gentle exercise
• Stress management and relaxation
• Massage