Pain Research
What is pain?
How can pain be treated?
Why is pain research important?
What advances have the Brain Research Centre made in pain research and treatment?
Would you like to learn more about pain research?
Who researches pain?
Would you like to support pain research?
What is pain?
The ability to sense pain depends on the proper functioning of several highly specialized components. Nociceptors are nerve cell endings whose function is to initially detect dangerous or harmful stimulants, such as heat or trauma, and prepare a “message” to be sent to the central nervous system for a reaction. This message, written in the form of neurotransmitters and other chemicals, is carried along nerve fibres, which are highly specialized pathways travelling from the nociceptors to the brain and spinal cord. When the message is received, the body initiates a response in an effort to reduce exposure to the harmful stimulus, such as jerking an extremity away from a heat source. Pain experienced in these kinds of situations is often referred to as nociceptive or acute pain, and is an important protective mechanism against extensive tissue injury following exposure to a damaging stimulus.
Unfortunately, in some individuals, pain can become dissociated from tissue injury, such that it is no longer biologically meaningful. If this pain persists for more than a few months, it is termed chronic pain and can have devastating effects on the lives of its sufferers. According to the Canadian Pain Society, 20 – 40% of Canadians are affected by chronic pain, with older people being more susceptible.
Neuropathic pain, which is pain that occurs as a result of a dysfunction of the nervous system, is an example of a particularly difficult to treat chronic pain condition. The cause of neuropathic pain is not well understood, but is thought to arise due to damage to nerves and/or the central nervous system (spinal cord and brain). This damage may occur for many reasons, including:
- ion gate malfunction
- trauma to the brain or spinal cord (e.g., stroke)
- infection (e.g., shingles)
- disease (e.g., diabetes)
- drugs (e.g., cancer therapies)
- psychological conditions
Neuropathic pain can exist even without continuous stimulation to nociceptors. This often severe pain can arise spontaneously or can be produced by the kinds of mild stimulants encountered in every day life, such as differences in temperatures, pressures of clothing against skin, and changes in light.
Chronic pain also sometimes exists in conjunction with, or as a result of, other common debilitating conditions, such as migraines and tension-type headaches; rheumatoid and osteo-arthritis; back pain, fibromyalgia, and temporomandibular disorders; and Crohn’s disease and irritable bowel syndrome. Like neuropathic pain, the cause of chronic pain in these common conditions is poorly understood, often leading to suboptimal treatment.
How can pain be treated?
Pain can feel like burning, shooting, stabbing, or electric shock sensations. It can be short-lived or long-lasting, and its cause is highly variable. As a result, treating pain can be difficult, and it is often under-treated. However, limited treatment options are available.
Nociceptors become increasingly sensitive with continued or repeated stimulation. For example, pain may be experienced after being sunburned. As well, a slight breeze or gentle pressure from clothing, for example, may cause significant pain at the sunburn site. This increased sensitivity is due to the release of compounds known as prostaglandins and leukotrienes, which act to sensitize nociceptors. Commonly used pain relieving drugs, such as aspirin and ibuprofen, interfere with prostaglandin production to reduce sensitization, thereby reducing pain. Other drugs, including opiates such as morphine and codeine, reduce pain by blocking the transmission of calcium into cells along the nerve fibres.
In spite of these treatment options, a large percentage of neuropathic pain patients do not receive adequate relief with current drugs. More research into the causes of pain, its mechanisms, and newer therapies are needed. The Brain Research Centre is at the forefront of developing new diagnostic benchmarks and treatment options.
Why is pain research important?
The diagnosis, treatment, and prevention of pain are challenging tasks. Pain varies considerably in the sensations it causes, as well as in the severity and duration of these sensations. As well, pain sensitivities and perceptions vary across age, gender, and culture.
Oftentimes, the cause of pain remains elusive, resulting in sufferers waiting long periods of time before seeking treatment. According to the Canadian Pain Society, many Canadians wait more than six months before seeking treatment. Left untreated, pain can lead to deterioration of quality of life, and both physical and psychological well-being. Furthermore, the cost to the Canadian economy is estimated to be approximately $6 billion annually due to lost productivity and health care utilization.
What advances have the Brain Research Centre made in pain research and treatment?
The Brain Research Centre has made great strides in pain research and treatment. We have a cadre of world-class investigators furthering our understanding of the cellular, molecular, and clinical mechanisms and manifestations of pain, and we are working to develop new pain therapeutics.
Some of our investigators are exploring the role and mechanisms of ion channels in order to develop new pain targets. Dr. Chris Ahern studies voltage-gated sodium channels – key regulators of excitability in nervous and muscle tissues – with an eye to using these channels as targets for the development of new drugs. Dr. Terry Snutch was the first scientist to describe the molecular basis for calcium channel heterogeneity in the cardiovascular, endocrine, and nervous systems. He founded and currently serves as Chief Scientific Officer for Neuromed Pharmaceuticals, a company developing new pain and other central nervous system-directed therapeutics. Neuromed currently has a novel, once-daily pain-alleviating drug in Phase III clinical trials. They are also the first company to develop an oral drug that blocks N-type calcium channels, a channel that is directly linked to pain signal transmission, thereby reducing pain.
Other investigators are working to expand our knowledge of how pain signals are transmitted in an effort to develop new drug targets. Dr. Brian Cairns investigates the mechanisms that underlie the transmission of pain signals, and seeks to identify peripheral targets that could lead to the development of novel drugs to treat musculoskeletal pain. Dr. Stephan Schwarz, the 2008 recipient of the Neuropathic Pain Research Award from Pfizer, is examining the use of intravenous lidocaine as a tool to identify novel drug targets for post-operative and neuropathic pain control.
Several other investigators are examining the effects and impact of pain on infants and children, as well as how to better assess and manage it in this population. Dr. Ruth Grunau recently confirmed that, along with recognized facial and heart rate changes, there are other behaviours unique to infants that indicate pain. One result of this work is that pain assessment in infants is improving. In addition, Dr. Tim Oberlander is examining infant pain reactivity as a "window" into early brain function, as well as investigating ways to improve pain assessment management among children with developmental disabilities. Dr. Peter Soja is examining how the sleeping brain dampens down sensory inflow through pain and other sensory pathways.
In addition, our investigators are exploring the role of pain in a wide variety of other situations, including sleep, migraines, neurodegenerative diseases, and more. These investigators, together with their colleagues, are leading the world in pain research and treatment.
Would you like to learn more about pain research?
Download a two-page summary on pain research.
Who researches pain?
Chris Ahern, PhD Department of Cellular & Physiological Sciences / Department of Anesthesiology, Pharmacology & Therapeutics
Ronald Barr, MD Department of Medicine
Brian Cairns, PhD Faculty of Pharmaceutical Sciences
Ruth Grunau, PhD Department of Pediatrics
Ujendra Kumar, PhD Faculty of Pharmaceutical Sciences
David A. Mathers, PhD, Department of Cellular & Physiological Sciences
Tim Oberlander, MD Department of Pediatrics
Ken Prkachin, PhD Department of Psychology, University of Northern British Columbia
Ernest Puil, PhD, Department of Anesthesiology, Pharmacology & Therapeutics
Stephan Schwarz, MD, PhD Department of Anesthesiology, Pharmacology & Therapeutics
Terry Snutch, PhD Michael Smith Laboratories / Department of Psychiatry
Peter Soja, PhD Faculty of Pharmaceutical Sciences
Sian Spacey, MD Division of Neurology, Department of Medicine
Jon Stoessl, MD Division of Neurology, Department of Medicine
Filip Van Petegem, PhD Department of Biochemistry & Molecular Biology
Joanne Weinberg, PhD Department of Cellular & Physiological Sciences
Would you like to support pain research?
The Brain Research Centre is committed to advancing our knowledge of the brain and to exploring new discoveries and technologies which have the potential to reduce the suffering and cost associated with disease and injuries of the brain. We invite you to help us deliver on this commitment.
