Seeing Pain: Showing Doctors Where it Hurts

Millions of Americans suffer with chronic pain, but many patients have been misunderstood or not listened to because there's nothing to see.

Now there is a new tool that is helping doctors visualize pain.

Pain affects more Americans than diabetes, heart disease and cancer combined. But for years, patients with chronic neck pain from an accident were met with disbelief. Now, a new diagnostic tool is helping pinpoint and see the pain for the first time, giving hope to the 60 million people suffering with chronic pain in the U.S.

Taking time to enjoy the tulips reminds former gardener Cora of her passion. Cora suffers from chronic pain.

But that was taken away from her 14 years ago when a car slammed into hers when he was distracted by a map. Cora says, "The next thing I remember, he was standing and shouting and thinking that he had killed us."

Cora was rushed to the hospital with whiplash trauma. She was soon released when doctors didn't see anything wrong with her x-rays. Once home, she began having severe headaches and neck pain and has been in constant pain ever since Unable to work or get back to gardening. With one in five people suffering from chronic pain, it's a scenario doctor Torsten Gordh sees often.

Torsten Gordh, PHD, MD, professor of pain medicine at Uppsala University Hospital in Sweden says, "There's been great difficulty for the patient and difficulties for the doctor because we haven't understood the pain problem in depth. We have only had a description, and that makes it difficult to work with."

He's part of a team at Uppsala University Hospital in Sweden that's developed a first of its kind tool to literally "see" where the pain is coming from.

A tracer marked with positrons is first injected into the bloodstream. The substance then pools together at the site of the pain, marking the inflammation. Doctors can pinpoint the site through the use of a pet scan.

A Swedish insurance company funded the trial to better understand the nature of pain, especially whiplash-related pain. The trial is ongoing, but the results could help both insurance companies and patients prove or disprove pain claims.


BACKGROUND: More than 50 million Americans live with chronic pain caused by various diseases or disorders, and each year, nearly 25 million people suffer with acute pain as a result of injury or surgery. While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, or even years.

SIGNS: Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).

WHIPLASH-ASSOCIATED DISORDER: Whiplash-associated disorder (WAD) is the term given for the collection of symptoms affecting the neck that are triggered by an accident. Whiplash is a non-medical term describing a range of injuries to the neck caused by or related to a sudden distortion of the neck associated with extension. Diagnosis occurs through a patient history account, head and neck examination, and X-rays to rule out bone fractures. This may also involve the use of medical imaging to determine if there are other injuries.

SEEING PAIN: Pain remains notoriously difficult to see and diagnose. Researchers in Sweden sought to see inflammatory processes in the neck region using the tracer C-D-deprenyl -- a potential marker for inflammation. Twenty-two patients suffering from WAD and 14 healthy controls were tested. WAD patients displayed significantly elevated tracer uptake in the neck. This suggests that whiplash patients have signs of local inflammation, which may serve as a diagnostic biomarker. Doctors can use a PET scan to see the location of the pain.
(SOURCE: Uppsala University Hospital)

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