"Throughout his body today, Pete has a strange feeling: “a weird radiating sensation,” as he describes it, an overall discomfort but not quite pain as you and I know it. He and others born with his condition have been compared to superheroes—indomitable, unbreakable. In his basement, where the shelves are lined with videogames about biologically and technologically enhanced soldiers, there is even a framed sketch of a character in full body armor, with the words painless pete. But Pete knows better. “There’s no way I could live a normal life right now if I could actually feel pain,” he says. He would probably be constrained to a bed or wheelchair from all the damage his body has sustained...
pharmaceutical researchers are now deep into clinical trials on a new type of drug that seeks to mimic Pete’s condition to treat Costa and others living with chronic pain. Such a drug would not merely dull inflammation the way ibuprofen does or alter our neurochemistry the way opioids do: It would block the transmission of pain signals from cell to cell without ruinous side effects on the brain or body...
Acute pain persists, but it also goes away. Acute pain is also easier to empathize with: Show someone an image of a pair of scissors cutting a hand, and the observer’s brain will react as much as if their own hand were being pinched.
Chronic pain, on the other hand, is a phantom: an enduring ache, a tenderness that does not turn off. It can be inflammatory (brought on by diseases like arthritis) or neuropathic (affecting the nerves, as in some cases of shingles, diabetes, or chemotherapy treatments). Some chronic pain never even traces back to a coherent cause, which makes it that much harder to understand. Give us broken bones, burn marks, blood—in the absence of proof (or personal experience), the hidden pain of others is easy to dismiss...
Waxman was interested in the sodium channels found in the membranes of neurons—portals that allow charged particles to flow in and out of the nerve cells. In particular, he believed that one of those sodium channels, Nav1.7, played an especially powerful role in how we experience pain. In his theory, a stimulus triggers the Nav1.7 channel to open just long enough to allow the necessary amount of sodium ions to pass through, which then enables messages of stinging, soreness, or scalding to register in the brain. When the trigger subsides, Nav1.7 closes. In those with faulty Nav1.7 channels, sensations that typically wouldn’t register with the brain are instead translated into extreme pain...
Xenon found a common trait among those with insensitivity to pain: mutations in a single gene, SCN9A, and the nonfunctioning sodium channel it encodes, Nav1.7...
“At least a half dozen companies are trying to develop sodium-channel blockers that preferentially or selectively block 1.7,” Waxman says. And while obstacles remain—ensuring that only the Nav1.7 channel is affected; creating compounds that will allow some pain to register without cutting it off altogether; surviving the rigors of FDA approval—he and many others see a way forward."
There is so much great, fascinating work going on in neuroscience on pain. The history of pain treatment is FASCINATING, all the ways that our species has encountered opium and then the last 200 years of trying to make them safe for chronic use (heroin was developed in the 19th century and advertised as the non-addictive version of morphine. Really).
And outside of drugs, there are studies on engaging the placebo effect and other "mind-body" methods to dull chronic pain - which can often be a progressive neurological disorder that emerges from acute pain, and which can get locked into these stress-inflammation-pain loops.
I think it's partly our society, and how we are encouraged to internalize our pain, grit our teeth and push through because that's what it means to be a strong-resilient-Western-individual. We end up wrapping it into our identities, instead of living lives where we can rely on our communities to help us deal with any pain that might emerge.
Also - call your state and federal legislators and make sure that they support research funding, applied AND basic. These findings are presented as a direct process of examining patients with specific diseases, but they rely on an incredible platform of basic research:
The human genome project was probably responsible for originally establishing the "normal" sequence of these genes - and then later, a basic cell biologist probably went searching for sodium channel genes based on sequence similarity to known sodium genes and "annotated" Nav1.7 (you can tell when something was found in a generalized screen when it has a boring, numbered name). There are whole labs that just work on the electrochemical properties of ion channels, and some grad student probably characterized the behavior of Nav1.7 and someone else solved the protein structure and showed which part of the protein did what and therefore which parts of the genetic sequence contributed to which functions. So, finally, when the two research groups described here were looking at these familial pain disorders, they were able to find the mutations that differed from the normal sequence, and identify how that would change the protein function and therefore the pain signaling properties of the neuron (I haven't even gotten into the basic research that let them but the neuroscience together!)
FB: this is why I do science -- "Pain has always been the price of being alive, but according to the National Institutes of Health, more than one in 10 American adults say that some part of their body hurts some or all of the time. That’s more than 25 million people. In study after study, more middle-aged Americans than ever before say they suffer from chronic pain...
Waxman pulled up an image of a normal person’s sodium channel on the screen, the strings of amino acids that form it neatly folded. Then he pulled up another image: The protein here was a tangled clump, amino acids zigzagging almost off the screen. “This is you,” he said.
“I’ll never forget,” Costa says. Her entire life, she could only tell others how she felt—she could never show them. To see the medical proof of her pain for the first time, Costa says, “was the most validating experience in my entire life.”"
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