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Vancouver Sun - Canadian researchers using high-tech imaging in efforts to validate chronic pain

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Published: 3 Oct 2011

Canadian researchers are trying to stamp out once and for all the skepticism faced by many who suffer severe, persistent pain. The revolution in research Canadians are helping to lead is aimed at showing just how real pain is.

Canadian researchers are trying to stamp out once and for all the skepticism faced by many who suffer severe, persistent pain. The revolution in research Canadians are helping to lead is aimed at showing just how real pain is.

Researchers are using high-tech imaging to show the human brain in the act of processing pain. They're discovering how unrelenting, day-in and day-out pain can change the brain's anatomy (pain shrinks the brain in some areas) and how those abnormal changes can be reversed with successful treatment. They're discovering just how often poorly treated pain after surgery morphs into chronic pain that can last for years.

In Quebec, 3,500 patients are being followed in what is believed to be the largest registry of chronic-pain patients in the world — a massive undertaking that could unlock answers to one of the most universal of all human experiences, including what factors predispose us to chronic pain, and what perpetuates it. The goal across this research spectrum is to reduce suffering and banish the idea that pain that doesn't respond to treatment — or that seems wholly out of sync with any physical finding — isn't genuine.

"There is a huge social change that is happening," says Dr. Fernando Cervero, director of the Alan Edwards Centre for Research on Pain at McGill University, one of the world's leading pain research centres. "We are in a way leading, but also society is leading it. People are saying, 'Why do we have to live with pain?'"

"You can take a picture of somebody's spine and it looks absolutely normal and perfect, and yet they have horrible pain. So where is the pain?" asks renowned pain researcher Dr. Ronald Melzack, professor emeritus of psychology at McGill University. "That's the pain we need to start concentrating on."

Pain, he says, used to get three pages in the medical textbooks. Pain was a sensation, he says, "it didn't mean suffering." Nearly 40 years ago, Melzack helped put a language to pain with the McGill Pain Questionnaire, a tool now used the world over to assess pain. It consists of 78 pain descriptors - words such as pounding, drilling, quivering, stabbing, shooting, exhausting, sickening, suffocating - to try to describe suffering. Each is rated on a five-point scale - the higher the pain score, the greater the pain.

But it was his "gate control" theory of pain that revolutionized pain science. In 1965, Melzack and his colleague, MIT neuroscientist Patrick Wall, published a theory that challenged the idea that there was a one-way, skin-to-brain "pain pathway."

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