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Easing the pain
Believe it or not, there is such a thing as good pain.
Good pain stops us from doing harmful things to our bodies, like touching a hot stove or twisting joints out of place. But it’s the bad pain — the kind that offers no value — that most interests Fernando Cervero.
The McGill University neuroscientist is trying to understand chronic pain that originates in internal organs and lasts for months or, in some cases, years. He is looking for more effective treatments of this type of pain, including in our brains and genes.
Cervero has written a book called Understanding Pain, which looks at the latest research into chronic pain and at efforts to develop more effective treatments. The book will be available from most online booksellers starting this month.
“Pain is not very glamorous,” says Cervero, director of the Alan Edwards Centre for Research on Pain. “You find people get labelled as complainers. Unfortunately, there is still a tradition in Western society of grinning and bearing it.”
Anti-inflammatory drugs and muscle relaxants are often used to treat chronic pain, but they don’t work for all patients. Severe pain resulting from injury is easier to treat, he says. Opiates such as morphine and codeine usually do the trick, but once the injury goes away, the pain does too.
Cervero worries most about those who suffer from chronic pain. Approximately 5 to 10 percent of people who have major surgery develop chronic pain. In people with nerve injuries, the percentage is as high as 20 to 30 percent.
“Why is that? That’s the really tricky question,” says Cervero. “We think genetic factors are involved. This is cutting-edge research. We’re still not in a position to treat it.”
The Canadian Pain Society estimates that one in five Canadians suffers from chronic pain. While the prevalence increases with age, 15 to 30 percent of children experience recurring or chronic pain.
The economic impact of suffering is steep. Research shows that the cost of health care and lost work days is an estimated $10 billion per year in Canada. This economic burden is greater than that of diabetes, heart disease and cancer combined.
Cervero wants to reduce both the economic and the personal toll by pinpointing target areas in the body for treatment. He was the first to identify sensors in internal organs that signal pain to the brain. Pharmaceutical companies, such as AstraZeneca, are supporting his work.
Cervero says his research would not have been possible without the support he received from the Canada Foundation for Innovation when he first arrived at McGill 10 years ago. It allowed him to buy the sophisticated electronic equipment needed to pick up the signals used to communicate pain.
Cervero believes the next 5 to 10 years will bring important discoveries about the genetic factors that contribute to pain, opening up even more effective targets for drugs.
“A pain pill for all is a thing of the past,” he says. “We are moving toward the personalization of pain medication.”