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Research on why we experience pain-Cancer Survivorship

New pain organ discovered in the skin

Researchers at Karolinska Institutet in Sweden have discovered a new sensory receptor organ that is able to detect painful mechanical damage, such as pricks and impacts. The discovery is being published in the scientific journal Science.

You don’t have to tell cancer survivors that pain causes suffering and results in substantial costs for society. What you might not know is that the Institute says there is a considerable need to find new painkilling drugs.

Survivors are well-aware that pain, particularly joint pain, is often a constant in our lives.  Recently, NHS hospitals have started to take pain more seriously and opened or enlarged pain clinics.  There is often a very long waiting list, but well worth enquiring about if you suffer.

In the meantime,pain is something survivors have to contend with – don’t think you are on your own.

Coping

I like the TLC attitude displayed by Dana-Farber, the great US Cancer hospital.

Anne Kelly, MSN, a nurse practitioner for the Breast Oncology Program in the Image result for image Anne Kelly Dana-Farber Center for Women’s Cancers at Dana-Farber, provides some advice on how patients can cope with Joint discomfort – one of the most frequent problems.

“Women may experience discomfort in hands, wrists or knees. … typically occurring … on both sides of the body. To prevent joint discomfort, Kelly encourages patients to “keep moving” and stay active”. She is a believer in exercise, but says “exercises do not have to be time-consuming or complicated; walking, yoga, or even just taking an extra flight of stairs can be effective”.

One of most effective ways of exercising is hydrotherapy; exercising in warm water This has a double benefit;  warmth of the water is not only soothing, but exercising in water helps you to be even more energetic, whilst.keeping joints active.

MD Anderson, the US Cancer hospital, say your doctor or nurse may recommend non-drug treatments for managing your cancer pain in addition to your pain medication. They offer a list of treatments that might help your medicines work better and relieve other symptoms, but say they should not be used instead of medication .

  • Biofeedback: A technique that makes the patient aware of bodily processes normally thought to be involuntary (blood pressure, skin temperature and heart rate). Patients can gain some conscious voluntary control of these processes, which can influence their level of pain.
  • Breathing and relaxation exercises: These methods focus the patient’s attention on performing a specific task, instead of concentrating on the pain.
  • Distraction: A method used to shift attention to a more pleasant event, object or situation
  • Heat or cold: Using temperature to facilitate pain control with packs or heating pads (this is my favourite, and I use an electric under-blanket in bed)
  • Hypnosis: A focused state of consciousness that allows the patient to better process information
  • Imagery: Using soothing, positive mental images that allow the patient to relax
  • Massage, pressure and vibration: Physical stimulation of muscles or nerves can assist with relaxation and relieve painful muscle spasms or contractions. In Europe most patients get massage almost automatically in cancer hospitals.
  • Transcutaneous electrical nerve stimulation (TENS): A mild electric current is applied to the skin at the site of the pain.

So what is this new Pain Organ

Researchers at Karolinska Institutet have now discovered a new sensory receptor organ in the skin that is sensitive to hazardous environmental irritation. It is comprised of glia cells with multiple long protrusions and which collectively go to make up a mesh-like organ within the skin. This organ is sensitive to painful mechanical damage such as pricks and pressure.

The study describes what the new pain-sensitive organ looks like, how it is organised together with pain-sensitive nerves in the skin and how activation of the organ results in electrical impulses in the nervous system that result in reflex reactions and an experience of pain. The cells that make up the organ are highly sensitive to mechanical stimuli, which explain how they can participate in the detection of painful pinpricks and pressure. In experiments, the researchers also blocked the organ and saw a resultant decreased ability to feel mechanical pain.

“Our study shows that sensitivity to pain does not occur only in the skin’s nerve fibres, but also in this recently-discovered pain-sensitive organ. The discovery changes our understanding of the cellular mechanisms of physical sensation and it may be of significance in the understanding of chronic pain,” says Patrik Ernfors, professor at Karolinska Institutet’s Department of Medical Biochemistry and Biophysics and chief investigator for the study.

Whatever pain your are experiencing, you are NOT a wimp if you seek help.  As more and more research is being carried out, doctors are discovering new  ways to help.  But it’s up to you to ASK for help.

The Karolinska research was carried out with financial assistance from ERC, the Swedish Research Council, the Knut and Alice Wallenberg Foundation and Welcome Trust.

Publication: “Specialized cutaneous Schwann cells initiate pain sensation”. Abdo H, Calvo-Enrique L, Martinez Lopez J, Song J, Zhang MD, Usoskin D, El Manira A, Adameyko I, Hjerling-Leffler J, Ernfors P. Science, 16 August 2019, doi: 10.1126/science.aax6452.

 

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