Pain. Just the word makes us wince. So, just imagine if you were subject to chronic pain. It seems that the more we are subject to pain in a certain region, the lower the threshold for manifesting subsequent pain.
The current hypothesis for this phenomenon is related to the changes to neurons (the nerve cell) that occur when they are ‘learning’. It seems that the number of cellular connections and the number of synaptic connections for the neuron increases during learning. As such, the connections that transmit pain are augmented as pain persists, so the threshold at which pain is perceived continually drops. (One wishes it would be the opposite!)
Right now, the preferred treatment for persistent pain is opiates- which, of course, are addictive and to which we develop tolerance (requiring higher and higher dosages). The other available choice is to administer cox (cyclooxygenase) inhibitors (such as aspirin, ibuprofen), with their dangers of gastric bleeding or kidney damage. Yet, these latter drugs rarely work beyond mild or moderate pain levels. But, there’s more to the story.
In general, if and when something is wrong with your body, it becomes “panicked”. An inflammatory response, one that harnesses vascular, cellular, and immune systems rallies to repair the injured tissue. That’s exactly the function these Omega 3’s and aspirin therapy provides.
It seems that aspirin promotes the ability of Omega-3 fatty acids to reduce inflammation. (Omega-3’s are found naturally in fish and flaxseed oils.). Two of these fatty acids are EPA (eicosapentaenoic acid) and DHA (docasahexaenoic acid), which are well known in their abilities to reduce the risk of asthma, heart disease (including atherosclerosis), and cancer.
Dr. Charles Serhan (Peter Bent Brigham and Women’s Hospital of the Harvard Medical School) determined that these compounds were metabolized in the body to lipid compounds he termed ‘resolvins’. [You can find a great review of this subject in the Journal of Thrombosis and Haemostasis: Systems approach to inflammation resolution.] Luckily, the resolvins reduce the inflammation, without suppressing the immune response (by blocking the production of pro-inflammatory chemokines). As stated above, aspirin ingestion promotes the metabolism of the Omega-3 fatty acids to these resolvins.
Now, there is a push to develop these resolvins as analgesics. The results are encouraging. However, the testing so far has been based upon administration of these chemicals via spinal injection, because their actions there are dramatic (blocking two different receptors, the TRPV1 [transient receptor potenital vanilloid 1] and the ChemR23 receptor] and there is no degradation of the compounds.
Since spinal injection involves a slew of undesirables (due to the potential side effects), finding another method of administration (and the stability of the drug to said administration) is the critical stalling point right now.
I read with much interest. Living with pain is hard and waiting for the development of different helps is frustrating at times.
shawn recently posted..Sex and Beads
Shawn…
That is the key point upon which you hit. Getting the help we need when we need it not only diminishes the pain, but can mean that potential addictions can be thwarted.
Roy
Fascinating research especially in light of the side effect problems associated with NSAIDs for pain management. I really liked your point about the “learning” that occurs within nerve cells – very interesting stuff!
Tor Constantino recently posted..4 Ancient Leadership Lessons
Thanks for your kind comments, Tor….
One only hopes this reaches the FDA for approval sooner than later.
So, if aspirin releases Omega fatty acids into our bodies, would it be just as helpful, if not more helpful, to take fish oil type substances to create a similar affect?
JRT recently posted..Which way do I go?
Taking fish oil does not mean that it would not be digested and, therefore, not available to our bodies, JRT. Taking a substance orally means it either must have its active component survive the digestive process, be absorbable INTO the body, and capable of transport to the point of action. That’s a lot of “ifs”…
Roy
Wow, what a relief that would be to millions of people! My dad and one of my best friends suffer chronic back pain. Hopefully, something will come to fruition in their lifetime. Thanks for sharing Roy!
Jenny recently posted..Take a Whiff of That!
Glad you found the post of interest, Jenny. I, too, am sanguine that something with fewer side effects will be in the offing soon!
Ouch! (somebody had to say it). I guess the Holy Grail would be to find a way to administer them orally. A lot of people would consider that invention more important than the flush toilet.
David @ solar ontario blog recently posted..Why Are These Swimsuit Models Sliding on Solar Panels?
Not sure these would survive our digestive system, David. That is one of the prime reasons why injection has been employed.
Roy
Shoot me up, just not in the spine, please. I don’t know what came first pain and then depression or depression and then pain. Maybe both arrived at the same time. I’ve had problems since I was in my teens. It would be incredible not to have any pain, but I’d probably have to be tied down because I would do stuff that would make what ever is causing the pain get worse (back for instance). Still I can dream. Thanks for the info, Roy. You always offer hope.
Ann recently posted..LinkedIn Groups Get You Going Places
Ah, Ann, we do know that hope is the opiate for the masses, right? (I figured that quote would fit right in with this subject’s discussion…)
Roy
Pain is a slippery slope. It makes sense that the longer you suffer, the lower your threshold. It wears you down and is exhausting. It leads to anxiety and depression. But those opiates are frightening. I’ve read about the withdrawals of these and it sounds worse than the initial pain. If there is another answer out there for pain, I hope they find it soon. Thanks for the information Roy! ~ Suerae
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One can only hope that these alternatives become available soon, Suerae!
Thank you, Roy. What an interesting article! Rich with information, and mercifully brief & to the point. It’s been a long time since I read layman-oriented science so carefully, and it was SO provocative.
For example, aren’t there additional avenues for delivering the “goods” to the bloodstream besides orally and with spinal injections. EVERYING has side effects, but how about rectally, if the stuff is water-soluble? How about subcutaneous or intramuscular injection? How about through the skin with DMSO, ointments, or a patch? How about eye drops or nose drops?
Just wondering, based on what I see advertised these days. And I’m sure I’ve overlooked some more possibilities. Have all of the above been tried already?
-Robbie
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Robbie-
I am sure they are looking at most of them. There was a certain logic to what they chose. The chemicals don’t stand up to the pH and enzyme actions within the digestive system. The spine is one of the places that is associated with the most intractable pain. (It’s amazing how many of us and how often are sidelined due to back pain.) A transdermal system test could fail because the patch would not provide sufficient dosage, even if the drugs were perfect. So, that would not be a first test. Rectal administration is not a preferred method any longer. I don’t know the eye safety for these drugs (and I’m guessing neither do they), so that would require additional testing not germane to the proof of concept. Nose drops may, indeed, prove a useful test concept.
Those were great thoughts, Robbie. And, it makes it clear for everyone that the administrative routes have barely been considered at this point.
Roy
Thanks, Roy,
A few more thoughts: Just curious. Beside the ones I mentioned, what other administrative routes are being considered. Do you know? Are you involved in this work, or are you just an interested bystander, like the rest of us?
If the spine was selected for being the site of intense pain, perhaps local application or injection to a painful site could be considered, rather than aiming for the bloodstream.
Do people still speak of the blood-brain barrier, and does this figure into the puzzle?
Well, very interesting, and I’ll be on the lookout for further developments. Thanks for tweaking my curiosity.
-Robbie
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lots of new info for me here
glad i came across your post
will bookmark your blog
Glad you did, Farouk! Thanks so much…
Roy
lots of new info for me here, glad i came across your post
will bookmark your blog
Farouk, I am so pleased that you came for a visit. I look forward to hearing from you again- soon!
Roy