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Will there ever be a cure for chronic pain?

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Re: Will there ever be a cure for chronic pain?

#91

Post by proverbialbunny »

jririi82zxn wrote: post #70

No. Or not in our lifetime, maybe is the better answer. My gut says a lot of “chronic pain” that ends up hardwiring the brain to be noticed. Reinforce a neural pathway often enough and it won’t quiet down. The buzz will be there and we can’t be sure our sore spot hurts or our brain simply can’t avoid that pathway. See phantom limb and similar.

Kind of, kind of not.

When one has enough chronic pain, they lay in bed for extended periods of time. This deteriorates the muscles, and a lack of muscle strength can create chronic pain, creating a feedback loop.

It's why chronic pain centers prescribe a physical therapist and muscle strengthening exercises.

Likewise, as you suspect when it comes to neurology, if something happens over and over again the brain creates a map for it, which when it comes to chronic pain can make things worse. One of the solutions found is to prescribe an antidepressant, even if the person isn't depressed, as it helps rewire those kinds of parts of the brain. This is why at chronic pain centers there is a psychiatrist too.

Once those two issues are reduced or removed the chronic pain is often minimized enough (and sometimes entirely removed) the source of the chronic pain can become easier to see. Often the pain is still there, but it's no longer masked. This then helps identify the issue. eg for me, despite being 20/20 I have eye strain. Switching to a 4k monitor helped a lot, but I wouldn't have noticed a reduction in pain if I hadn't have gone through the physical therapy and been on an antidepressant for a couple of months.

Re: Will there ever be a cure for chronic pain?

#92

Post by proverbialbunny »

misnome wrote: post #27
erentz wrote: post #19

Earlier quoted context omitted.

It's not quite as unknown as commonly believed. At least 40% of fibromyalgia have observable neuropathy on biopsies pointing to a process that is damaging nerves. The "what" is still unknown. But the parent is correct to say for fibromyalgia patients the optimal solution is a treatment (or cure) targeting that damaging process, rather than a pain killer. This is not to say better pain killers aren't valuable, they ob…

This is a bit like, and as helpful as, saying “Chemotherapy is pointless, just find a cure for the cancer”

Chemotherapy is the known cure for cancer, so a more accurate statement would be saying, "Pain killers are pointless, just find a cure for the cancer."

But no one is saying painkillers is pointless. Parent is saying painkillers should be temporary. I suspect they forgot to mention the "in an ideal world" bit.

Re: Will there ever be a cure for chronic pain?

#93

Post by proverbialbunny »

dsfyu404ed wrote: post #16
juancn wrote: post #2

Should there be one? Pain is a symptom of something else, treat the root cause. Managing pain should only be a temporary measure.

When it's a symptom of some part of your body being worn out there's usually no treating that.

Actually, that is a common issue with chronic pain, and thankfully that's far from the truth.

Chronic pain clinics have a physical therapist that shows muscle building exercises, so the body stops being worn out.

However, depending on what the kind of wear is, as paradoxical as it seems, going for a walk for at least 20 minutes, can charge an exhausted body more than laying down without napping.

Re: Will there ever be a cure for chronic pain?

#94

Post by kirrent »

dghughes wrote: post #86

My dad has rheumatoid arthritis and is in constant pain. Even humeria doesn't help much. Now I have started waking up in the morning with hands so stiff I can barely make a fist. The pain doesnt bother me as much as the fear of being doped up on opioids. And the fact organ damage goes along with rheumatoid arthritis. And to top it off every nut around you says weed or some diet will cure you. It's always cure not mai…

I'm sure you're already on top of all of this and I hope you'll forgive the tangent, but if you're starting to get RA symptoms you should be acting now. It used to be the practice of rheumatologists to wait to treat until symptomatic relief was required by patients. That's no longer the case. The earlier you act and get on DMARDs (and you might even need to try a few before getting one that works or finding the one that works best. Humira was completely ineffective for me), the less cumulative joint erosion you'll experience, the sooner you'll likely be in remission, and the more likely you'll be to experience a later sustained DMARD-free remission.

Even if that's not the case and DMARDs don't completely solve the problem for you, there's a lot of options before opiods for symptomatic relief. From panadol, through NSAIDs (including the magical COX-2 selectives), and even steroidals.

Don't give up hope too early. Three years ago I couldn't dress myself. Today I just got back from a rock climbing holiday.

Re: Will there ever be a cure for chronic pain?

#96

Post by rjurney »

CuriouslyC wrote: post #72
rjurney wrote: post #39

Earlier quoted context omitted.

There is usually no cure for chronic pain. This is medical fact. Your case is not descriptive. It is usually not caused by scar tissue, or an infection. For example MRI reports are only slightly correlated with actual spinal pain. It generally involves an up modulation of pain sensation in the peripheral and central nervous system. It is worthwhile to investigate the cause but most people don't find a cure like you d…

You're falling into the classic trap of thinking doctors know everything, but sorry to say that's not even close to true. Most doctors know next to nothing about myofascial pain (even many that really should). I've seen multiple cases of mobility impairment and chronic pain that even well a respected orthopedic surgeon thought required surgery be corrected by aggressive bodywork, including trigger point myofascial re…

No, I read science myself. I’ve read hundreds of journal articles. I know the condition. I read pharmacology textbooks.

You’re espousing hippiedom and it’s top comment because of left wing ignorance.

Re: Will there ever be a cure for chronic pain?

#97

Post by ericb »

einpoklum wrote: post #85

> Will there ever be a cure for chronic pain? This is like asking "Will there be a cure for chronic being-sick?" - this is meaningless. Chronic pain has innumerable possible causes. Suppressing the symptoms to stuff is not a cure.

If you look at the causal end, sure. But if you look at the symptom side, why not?

At the end of the day, pain is reducible to neurons firing in succession. If you can stop it, interrupt it, filter it or block it, you would have something.

Re: Will there ever be a cure for chronic pain?

#98

Post by rjurney »

avgDev wrote: post #63
rjurney wrote: post #54

Earlier quoted context omitted.

Have you tried the Butrans patch? It is buprenorhpine and as of February, 2018 there is no legal restriction on it under CDC/FDA policy: unlimited prescriptions. No special license required to prescribe it (it is against regulation to use the patch for addiction). It is now generic ($160/month with a coupon, usually requires a prior authorization), and doesn't: * Get you high * Make you drowsy * Addict you (yes, you'…

Good list. I tried some items on the list, I am still working on seeing what works. Currently trying PT to see if tendons will improve, and NSAIDS but those don't seem to work.

Good to hear, never give up. PT is the first way to go, and it’s worth trying different forms like Yoga, anything that can work the painful part gently, and retrying it periodically if it doesn’t work. If you’re missing opioids, I’d definitely request the Butrans patch. Sorry, I’m an enthusiast:) For me it’s side effect free, maybe a very, very slight sedation, but I’m not even sure it is so mild.

Re: Will there ever be a cure for chronic pain?

#99

Post by andrewl »

avgDev wrote: post #8

Oof. To answer the headline, there already is a cure to chronic pain and it is called correct diagnosis. When i was 21 I had chronic pain for 8 months, doctors gave me anti-biotics, NSAIDS, steroids.....but pain was just there. After months of research I found a surgeon in California, who performed surgeries on "Sports Hernia", almost like inguinal hernia without any bumps. I flew out to have the surgery, pictures ta…

There are many mentions and discussions of fluoroquinolones on YC News, including my own recommendation [1] to be very careful with them, based on personal experience. Also, the spelling is fluoroquinolone, not flouroquinolone. (That is, flUOro, not flOUro.). I'm not being picky; I just want people to be able to successfully search for the term.

The discussion surrounding my comment is quite interesting, too, and worth reading.

[1]https://news.ycombinator.com/item?id=13275535

Re: Will there ever be a cure for chronic pain?

#100

Post by tomhoward »

rjurney wrote: post #95
virtuallynathan wrote: post #76

Earlier quoted context omitted.

Says who?

Modern medicine!

The root commenter didn't claim anything that your earlier comment contradicted. They just explained that they found a correlation between diet and pain (along with other physiological symptoms). Nobody said anything that excluded the notion that the pain was a symptom of an illness. Indeed, when is pain ever not a symptom of illness or injury?
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