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Neuralgia Pain Therapy - New Developments

Neuralgia = pain at the nerve endings, usually induced by a disturbed "food" supply of a nerve.

The requirement for these new developments was the research of the pathways, which are sending the pain impulses from the pain location over the spinal cord to the brain. A key function are playing by the nerve cells send and received substances, called transmitters. These transmitters can either activate the unpleasant impulses, or dampen them. Whereas by short pain the thunderstorm of neurons in the brain is passing by soon, the hyper-sensitivity of the nerve cells by chronic pain stays.

In animal experiments at the Max Planck-Institute in Munich was recreated how the nerve cells of the marrow, when constant provoked, started to over-react even without new or more outer pain impulses. During the process of constant irritation the cell started changing its characteristics: it produced new proteins, changed its reaction ability and thus became a totally "new" cell. 

Such a sensitive, finally genetically re-build nerve cell is then answering to even the weakest stimulus with a strong discharge of transmitters. The discharge of protecting endorphins, chemical messengers, which function as bodily pain breaks, is being inhibited: The pain impulse is given ahead to the brain as a constant bombardment, stopped by nothing in its way.

Human patients can find relieve with the help of a psychological treatment method, the Biofeedback. Normally subconscious functions like heart frequency, muscle tension or electrical brain activity can be made optical and acoustical with the help of sensors and the "bio feed back instrument". This way the patient is experiencing the changes through pain and learns at the same time to 'milden' the pain over a so called "positive feedback system".

Currently in clinical trials pain medication of the future are being researched, which are a cocktail of several substances and are blocking the various pain channels in the body. In over 80 % of  migraine - patients  the new substance group, the so called "Serotonin-Agonists" have proven themselves as very helpful: serotonin [1], a neurotransmitter, influences the disturbed regulation of the blood vessel tension.

Following was observed in these patients by  the Max Planck researches; patients lived for several weeks pain free after years of suffering. During this period without constant pain impulses the nerve cells changed back to their initial - orgine state of  reaction. The pain memory was de-programmed.

The potency of the Biofeedback, which is showing results after about 15 sessions, has been proven in over 100 studies world wide. For example the common pain of muscle cramping was relieved in 60% of all patients tested or so far helped that the patients didn't need any further treatments. In the control group, where the patients received  the usual drugs, the success rate was just 25 percent.

[1] Serotonin: A hormone, also called 5-hydroxytryptamine, in the pineal gland, blood platelets, the digestive tract, and the brain. Serotonin acts both as a chemical messenger that transmits nerve signals between nerve cells and that causes blood vessels to narrow. Changes in the serotonin levels in the brain can alter the mood. For example, medications that affect the action of serotonin are used to treat depression.

You may want to read about the brain and pathways 

Now we know all about development of pain and the dangerous aspects of chronic and neuropathic pain and can relate it to our HS horses, we are able to imagine what pain they must suffer. Let's have a look at the factor STRESS and its role in HS.

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References:
Physiobiolgie des Schmerzes, 1998 Urban & Vogel;
Biologische Physiology, 2002 Springer Berlin; 
Schmerzmessung und Schmerzdiagnostik, Oskar B. Scholz, 1997, Karger, Freiburg i.B.

 

 

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