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Effective, long-term treatment for chronic pain

A new review paper on an effective and long-term therapy for chronic pain found that the non-invasive ‘Scrambler Therapy’ can yield significant relief for approximately 80 to 90 percent of patients with chronic pain. The review, published in mid-July by researchers at the Johns Hopkins Kimmel Cancer Center in the United States, also noted that scrambler therapy was more effective and longer lasting than the non-invasive transcutaneous electrical nerve stimulation (TENS) therapy currently prescribed to many patients. 

Scrambler therapy, which has been around since 2009 and has received approval from the US Food and Drug Administration (FDA), is less well known than TENS, on account of not much data being available on its effectiveness in real-world situations. The researchers at Johns Hopkins aimed to fill this void by evaluating the efficiency and efficacy of scrambler therapy on its own, and in relation to other chronic pain-relieving therapies in the market.

Estimates show that globally 1 in 5 adults suffer from pain and another 1 in 10 adults are diagnosed with chronic pain each year. The importance of finding an effective, long-term solution to chronic pain lies in the fact that chronic pain affects people everywhere and there are very few, if any, long-term solutions that provide relief to this debilitating condition. To gain a better understanding of chronic pain, it helps to find out what pain is, how it manifests, and why we feel pain.

Pain is basically an indication that something in the body is not functioning as it should, and that certain actions need to be taken or avoided. It is an unpleasant sensation that may mildly or significantly impact the physical or emotional wellbeing and quality of life of individuals. Pain can be temporary or permanent and can range in intensity from being almost imperceptible to mild or excruciatingly unbearable.

Pain, which often manifests in the form of a tingling, pricking, stinging, burning, aching, or a shooting sensation, is also a complex experience that varies widely between people, even among patients suffering from similar injuries or illnesses. Although most pains go away after a time on their own or with treatment, there are other pains that can persist and develop into long-term chronic pain, which is often the debilitating symptom of many underlying diseases.

We sense pain when  thousands of specialized sensory nerve cells called nociceptors spread throughout the body respond to stimuli from damaged tissue, or tissues facing a threat of damage, or indirectly from chemicals released by damaged tissue. The stimulus triggers an electrical impulse that travels through nerves from the site of the injury or diseased area to the spinal cord and up to the brain. 

Thalamus is a region of the brain that receives pain signals and then distributes them to appropriate  brain regions, including those in the cortex — which process the sensory information and generates the experience of pain. Many other regions of the brain have also been associated with characteristics of pain generation.

There are also regions in the brain that help to dampen or decrease pain by sending signals down from the brain through nerves in the spinal cord to the area of pain, which block or interfere with the intensity of incoming pain signals to reduce the pain experience.  

All chronic pain and almost all nerve and neuropathic pain result from two things: pain impulses coming from damaged nerves that send a constant barrage up to pain centers in the brain, and the failure of inhibitory cells to block those impulses and prevent them from becoming chronic. By blocking the pain impulses going to the brain and stimulating the inhibitory system, it is possible to reset the brain area that receives and responds to chronic pain. 

Scrambler therapy works by administering electrical stimulation through the skin via electrodes placed in areas of the body above and below where chronic pain is felt. The goal is to capture signals emanating from the nociceptors in the area experiencing pain and replace it with signals coming from adjacent areas experiencing no pain, thereby ‘scrambling’ the pain signals sent to the brain.

The review by researchers at Johns Hopkins found that patients receiving three to 12 half-hour sessions of scrambler therapy experienced substantial, and in some cases permanent relief from chronic pain. Proponents of the new therapy say it is effective, non-invasive and significantly reduces the use of opioids prescribed for chronic pain.

The current TENS therapy also administers low-intensity electrical signals through the skin, but it uses a pair of electrodes at the sites of pain. However, TENS therapy was found to be less effective than scrambler, and the relief provided by TENS was short-lived, with the pain returning when the electrical impulse was turned off. On the other hand, pain relief from scrambler therapy sustained for months or even years, and sometimes permanently after the treatment sessions are completed

The researchers believe that their new review would provide the authentication for Scrambler to be employed in more clinical surroundings and could significantly benefit chronic-pain patients.

Food, mood and how healthy swaps make a difference

The influence of food on mood is well-known but how this relationship works is less well-understood. The phrase, ‘you are what you eat’  has often been used to explain the fatigue and weakness we experience when we do not eat for an extended period, or the bloated, or sluggish feeling we get when we have eaten too much, or when we eat foods that do not agree with us. 

Besides its physical effects, food has also been shown to impact our mental health.

Previous studies have established that what we eat not only affects our physical health but also our mental wellbeing. A new study by researchers at Washington University in the United States has added to the compendium on food intake and mental health by linking a diet high in the consumption of fried foods, in particular fried potatoes, with increased anxiety and depression.

The study involved 140,728 people and revealed that regular consumption of fried foods carries a 12 percent higher risk of anxiety and a 7 percent greater risk of depression. Results from the new study are a  further vindication of decades of research showing that fried and unhealthy foods in the standard Western diet increase the risk of common chronic diseases and mental health conditions. 

One of the reasons that fried foods are associated with higher instances of anxiety and depression is that they have been shown to contribute to neuroinflammation, or inflammation in the brain, by producing compounds known as advanced glycation end-products (AGE) which adhere to tissue, damage them, and cause inflammation. 

The inflammation then blunts the areas of the brain that are associated with reward and decreases the release of dopamine, a type of neurotransmitter and hormone that plays a key role in many important body functions. High or low levels of dopamine are associated with several mental health and neurological diseases. Low levels of dopamine have been linked to schizophrenia. attention deficit hyperactivity disorder (ADHD), Parkinson’s disease, restless legs syndrome, and a lack of motivation. among others.

However, it needs to be pointed out that the function of a single neurotransmitter like dopamine cannot be viewed in isolation of other neurotransmitters, or other chemicals in your brain or body, as many of them interact with each other. Moreover, doctors are still undecided on whether high or low levels of dopamine cause disease, or it is the disease that leads to lower or higher levels of dopamine, or whether both are involved.

Fried-food lovers everywhere who may be dismayed by the new findings can take heart in knowing that by paying closer attention to what we eat, it is possible to help reduce our risk of some mood disorders. For instance, studies have shown that mental health outcomes can be vastly improved when people follow a diet high in anti-inflammatory foods for 12 weeks.

Some of the healthy swaps that a person could make to reduce diet-induced inflammation include choosing cooking methods like poaching, stewing, steaming, and boiling rather than dry, high-temperature cooking. Oven-frying or air-frying can be great options as well because you use far less oil.

Replacing tropical oils, such as coconut- or palm-oil  that are high in saturated fats with extra-virgin olive oil, avocado oil, or rapeseed oil, can also help reduce inflammation. Additional benefits can be gained by swapping fried items with baked or grilled products such as baked potatoes and grilled chicken and adding in more whole foods like nuts, seeds, fruits, vegetables, and whole grains.

In general, doctors recommend patients to follow a healthy lifestyle by eating a variety of whole plant foods with plenty of fruit, vegetables, whole grains, beans, nuts, and seeds; engage in  regular exercises’ manage stress; get sufficient restful, quality sleep; and to avoid risky substances such as tobacco, alcohol and drugs.

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