Tuesday, 20 February 2018

Neuropathy Research Goals Down Under

Today's Australian post from healthtimes.com.au (see link below) doesn't really tell us anything we don't know about neuropathy but it does indicate the directions in which research into neuropathy is going. You may have noticed that in the last year, the emphasis is moving towards a holistic approach towards nerve pain treatment. What does that mean? Well, it basically means that current thinking admits that there is no single solution to nerve pain but that a combination of approaches, therapies, drugs and treatments, is most likely to achieve success. Only time will tell if this is correct but long-term neuropathy patients will be going; 'Duh! We've known that for years!' The problem is, which treatments are best and can any treatments act as blanket therapies for all neuropathy patients. Given the uniqueness of neuropathy to the individual, the answer is likely to be no. This article announces new research goals in Australia (although all research is global these days) and presents one doctor's ideas about upcoming research.

New research aims to find allied health solutions to neuropathic pain
Article by: Nicole Madigan | Published: 13-02-2018

As survival rates for serious medical conditions such as cancer and stroke increases, along with the diagnosis and management of other lifelong ailments such as diabetes, many patients face a life of enduring neuropathic pain.

Currently, this type of persistent pain is most commonly treated through surgical or pharmaceutical intervention, which have the potential to cause additional undesirable side effects.

Reducing persistent neuropathic pain through methods other than medication or surgery will be the focus of new research conducted Professor Michel Coppieters, the newly appointed Menzies Foundation Professor of Allied Health Research at Griffith University.

The research will concentrate on understanding the specific mechanisms of neuropathic pain, how it evolves, improving the way it is diagnosed and the potential for non-surgical and non-pharmacological management.

“Neuropathic pain is common, but very difficult to manage,” says Professor Coppieters.

“And it is pain that serves no purpose."

“In contrast to some other types of pain, it is 100% dysfunctional.”

Neuropathic refers to pain is that which originates from the nervous system itself.

“It can be from the peripheral nervous system or central nervous system,” says Professor Coppieters.

“For neuropathic pain from the central nervous system, think conditions like spinal cord injury or stroke, though these are not my domain.”

Neuropathic pain from the peripheral nervous system may be the result of a number of common scenarios, such as:-

Compression or entrapment neuropathies, such as carpal tunnel syndrome or radiculopathy
Diabetes (diabetic neuropathies)
Neurotic medication, such as chemotherapy.

“For example, following breast cancer treatment, 20 - 60 percent of of women develop neuropathic pain in their arm, and some may experience significant functional limitations,” says Professor Coppieters.

“Considering the increased survival rates and longer life expectancy, prevention and successful management of these side effects is important as they can have a significant impact on people’s lives,” he says.

“There may also be a neuropathic pain component in low back pain, neck pain, knee and hip osteoarthritis, etc.”

But Professor Coppieters says it’s important to note that the distinction between the peripheral and central nervous systems is largely artificial.

“Following peripheral nerve injuries, changes occur in the central nervous system which typically increase the pain intensity.

“The umbrella term for this is central sensitisation.”

To date, there have been no similar research projects undertaken at the university, which Professor Coppieters says will concentrate on better understanding the conditions that affect the musculoskeletal system, in order to develop better clinical diagnoses and management strategies.

“Pain is largely influenced by the immune system,” he says.

“Neurons in our brain and spinal cord are outnumbered by other cells, such as glia cells, which are immunocompetent.

“The research aims to understand the mechanisms of neuropathic pain better, in order to prevent and better manage pain.”

To more effectively manage neuropathic pain long term, Dr Coppieters says it is important to be able to identify in advance which patients are likely to respond positively to a particular interventions, and which patients will not.

“We also like to understand how that treatment works,” says Professor Coppieters.

“The research will focus on specific populations and the impact of exercise and pain education on those populations.

“For example, which patients with back pain or neck pain respond well to physiotherapy and exercise, why do they get better and which pathological mechanism has changed?”

Along with measuring the impact of physiotherapy and exercise, Professor Coppieters says pain education of patients and their relatives will be a primary component of his research.

“It’s a neuroscience based pain education: empowering patients with knowledge about pain."

“What is it, what does it mean, what affects it?"

“We are merging fields of neurobiology and psychology.”


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