chronic pain

MRI shows neural differences with teeth grinding and jaw pain

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An interesting article titled “Neural Correlates of Tooth Clenching in Patients with Bruxism and Temporomandibular Disorder–Related Pain,” written by Theo J. M. Kluskens and et. al. appears in the Journal of Oral & Facial Pain and Headache (volume 37, Issue 2, Spring 2023, Pages 139–148). The authors sought to measure brain activity in patients with teeth grinding and jaw pain using functional magnetic resonance imaging (fMRI) to investigate whether differences when compared to those without had differennces in pain and/or neural activity. The researchers explored brain activity in 40 patients, 21 of those that bruxism and TMD pain and the remaining 19 patients were controls. The patients were asked to do a tooth-clenching task while they were having their brain scanned in a 3T MRI scanner. Patients had to mildly or strongly clench their teeth for 12 seconds and were … Read more

Low-Dose Naltrexone as An Alternative to Opioids for Wisdom Teeth Removal

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Before on this site numerous posts have discussed how many feel dentists and oral surgeons prescribe (or in the past have prescribed) too many opioids for their patients to help manage pain of dental procedures like wisdom teeth removal, see for example the post Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal?. In recent years there have been investigations into alternatives to opioids for dental procedures and also for chronic pain management when opioids in the past were more regularly prescribed for as well. One such approach is to prescribe a combination of ibuprofen and acetaminophen as discussed in the articles New Research Being Conducted at Rutgers for Opioid Alternatives Could Lead to Less Potential Drug Abuse for those Having Wisdom Teeth Surgery and Reducing Opioids in Oral and Maxillofacial Surgery. Recently, there have been articles and … Read more

Exploring opioid deaths in chronic pain patients

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Research has found that over half of patients who died from an opioid overdose had been diagnosed with chronic pain and many had psychiatric disorders. The study was conducted by researchers at Columbia University. According to the U.S. Centers for Disease Control, the number of opioid-related deaths has quadrupled in recent years, from 8,048 in 1999, to 33,091 in 2015, and the researchers were interested in learning more about what lead those patients to take opioids. The researchers analyzed clinical diagnoses and filled medication prescriptions for 13,089 adults in the Medicaid program who died of an opioid overdose from data collected between 2001 and 2007. During the last year of life, more than half of these adults (61.5%) had been diagnosed with chronic pain and many had also been diagnosed with depression and anxiety. This included 59.3% who were diagnosed with … Read more

Target specific brain cells to help with neuropathic pain

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Researchers from Rutgers University have explored treating chronic neuropathic pain which affects over 1 million Americans. Neuropathic pain results when nerve damage is caused due to injury, surgery or a some disease. Researchers showed that pain could be reduced in animals when microglia brain cells are targeted which are supposed to provide immunity. The researchers say that the microglia brain cells are supposed to be beneficial to the nervous system but in those with neuropathic pain these cells known as microglia have proliferated and instead become toxic. The researchers say that if they catch the injury within one to five days to inhibit microglia after nerve injury the development of chronic pain can be partially reversed. Neuropathic pain persists after the nerve has healed and is often resistant to normal pain medications. In lab mice the researchers used chemotherapy drugs to prohibit the microglia brain immune … Read more

Electric Stimulation of Brain Releases Powerful Painkiller

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Researchers have been exploring delivering electricity through sensors on the skulls of chronic migraine patients and have found a decrease in the intensity of pain of their headaches. A recent study published in Frontiers in Psychiatry has shown that when electricity is sent to certain regions in the brain of a patient with chronic, severe facial pain it releases an opiate-like substance and powerful painkiller. In the study, researchers administered a radiotracer that reached important brain areas in a patient with trigeminal neuropathic pain. They then applied electrodes and electrically stimulated the skull right above the motor cortex  for 20 minutes during a PET scan which is known as transcranial direct current stimulation (tDCS). The radiotracer was designed to measure the local brain release of mu-opioid, a natural substance that alters pain perception. The researchers argue that this is the … Read more