Every year millions of Americans are affected by chronic neuropathic pain.
This is a different kind of pain than what you might have with arthritis, or a degenerative disc in your spine. “Neuropathic” means that the pain is from damaged nerve fibers that send signals to the brain’s pain centers. Neuropathic pain can be caused by spinal cord or nerve injury, and in some cases as a result of stroke or cancer.
“Chronic” means that it lasts for six months or longer. This ongoing pain can lead to depression and anxiety, and may interfere with work and normal daily tasks.
At its worst chronic neuropathic pain is debilitating and may not respond to conservative treatments such as medication or physical therapy.
One of the challenges of treating chronic neuropathic pain is that chronic pain is different than short-term pain. Chronic pain activates areas of the brain that deal with depression, anxiety, and motivation, in addition to the areas that sense physical pain.
In other words, patients with chronic neuropathic pain don’t just hurt, they suffer. Relief is no longer a matter of treating “just” the pain itself. For complete relief, the emotional aspects of that pain, the suffering and depression, must be treated too.
In a recent paper in Neurosurgical Focus, Dr. Sheth talks about studies on an area of the brain called the dorsal anterior cingulate cortex, or the dACC. The dACC is a part of the brain that handles, among many other things, the emotions surrounding pain. Dr. Sheth says that neurosurgeons have long been interested in this area of the brain as a potentially promising target for treating severe neuropathic pain and its emotional aspects.
Dr. Sheth has done a great deal of research on using deep brain stimulation to treat symptoms of severe psychiatric disorders. Deep brain stimulation is a procedure that involves placing tiny electrodes into the brain. These electrodes send a small electrical current to the precise region of the brain where the patient’s symptoms originate. The current disrupts the brain’s activity in that area, which can relieve symptoms.
Deep brain stimulation has been successfully used to treat debilitating symptoms of obsessive compulsive disorder and Parkinson disease. Dr. Sheth thinks using deep brain stimulation on the dACC might not only relieve the sensation of the pain itself, but also the depression and anxiety that go with it.
Deep brain stimulation is only used in the most severe cases, and only when other treatments have failed to bring relief. For patients with severe cases of chronic neuropathic pain, Dr. Sheth’s research may hold promise for relief.
You can read the entire article here.
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