If you've ever taken a big bite of wasabi, you know what comes next: a painful zing that creeps over your whole scalp.
You aren't the only animal that feels this way. The condiment's sinus-burning kick comes from a chemical compound called allyl isothiocyanate, or AITC, that actively damages proteins within cells. Flies and flatworms shun it, as do miceand wolf spiders. "Practically every animal you look at will avoid AITC," said Gary Lewin, a molecular physiologist at the Max Delbrück Center for Molecular Medicine in Berlin.
But there is one exception. In a paper published Thursday in Science, scientists including Dr. Lewin showed that the highveld mole rat, a rodent found in South Africa, is entirely impervious to the substance.
The study "demonstrates the power of studying naturally occurring differences in pain sensitivity," said Ewan St. John Smith, a neurobiologist at the University of Cambridge, who was not involved in the research. The work could eventually lead to more effective pain treatment in humans.
More ...
https://www.nytimes.com/2019/05/30/science/mole-rats-pain.html
Friday, May 31, 2019
Wednesday, May 22, 2019
Millions Take Gabapentin for Pain. But There’s Scant Evidence It Works. - The New York Times
One of the most widely prescribed prescription drugs, gabapentin, is being taken by millions of patients despite little or no evidence that it can relieve their pain.
In 2006, I wrote about gabapentin after discovering accidentally that it could counter hot flashes.
The drug was initially approved 25 years ago to treat seizure disorders, but it is now commonly prescribed off-label to treat all kinds of pain, acute and chronic, in addition to hot flashes, chronic cough and a host of other medical problems.
The F.D.A. approves a drug for specific uses and doses if the company demonstrates it is safe and effective for its intended uses, and its benefits outweigh any potential risks. Off-label means that a medical provider can legally prescribe any drug that has been approved by the Food and Drug Administration for any condition, not just the ones for which it was approved. This can leave patients at the mercy of what their doctors think is helpful.
Thus, it can become a patient's job to try to determine whether a medication prescribed off-label is both safe and effective for their particular condition. This is no easy task even for well-educated doctors, let alone for desperate patients in pain.
Two doctors recently reviewed published evidence for the benefits and risks of off-label use of gabapentin (originally sold under the trade name Neurontin) and its brand-name cousin Lyrica (pregabalin) for treating all kinds of pain.
(There is now also a third drug, gabapentin encarbil, sold as Horizant, approved only for restless leg syndrome and postherpetic neuralgia, which can follow a shingles outbreak.)
The reviewers, Dr. Christopher W. Goodman and Allan S. Brett of the University of South Carolina School of Medicine, found the drugs, called gabapentinoids, wanting in most cases for which they are currently being prescribed.
More ...
https://www.nytimes.com/2019/05/20/well/live/millions-take-gabapentin-for-pain-but-theres-scant-evidence-it-works.html?
In 2006, I wrote about gabapentin after discovering accidentally that it could counter hot flashes.
The drug was initially approved 25 years ago to treat seizure disorders, but it is now commonly prescribed off-label to treat all kinds of pain, acute and chronic, in addition to hot flashes, chronic cough and a host of other medical problems.
The F.D.A. approves a drug for specific uses and doses if the company demonstrates it is safe and effective for its intended uses, and its benefits outweigh any potential risks. Off-label means that a medical provider can legally prescribe any drug that has been approved by the Food and Drug Administration for any condition, not just the ones for which it was approved. This can leave patients at the mercy of what their doctors think is helpful.
Thus, it can become a patient's job to try to determine whether a medication prescribed off-label is both safe and effective for their particular condition. This is no easy task even for well-educated doctors, let alone for desperate patients in pain.
Two doctors recently reviewed published evidence for the benefits and risks of off-label use of gabapentin (originally sold under the trade name Neurontin) and its brand-name cousin Lyrica (pregabalin) for treating all kinds of pain.
(There is now also a third drug, gabapentin encarbil, sold as Horizant, approved only for restless leg syndrome and postherpetic neuralgia, which can follow a shingles outbreak.)
The reviewers, Dr. Christopher W. Goodman and Allan S. Brett of the University of South Carolina School of Medicine, found the drugs, called gabapentinoids, wanting in most cases for which they are currently being prescribed.
More ...
https://www.nytimes.com/2019/05/20/well/live/millions-take-gabapentin-for-pain-but-theres-scant-evidence-it-works.html?
Monday, May 20, 2019
Why Does The Brain Connect Pain With Emotions? : Shots - Health News : NPR
When Sterling Witt was a teenager in Missouri, he was diagnosed with scoliosis. Before long, the curvature of his spine started causing chronic pain.
It was "this low-grade kind of menacing pain that ran through my spine and mostly my lower back and my upper right shoulder blade and then even into my neck a little bit," Witt says.
The pain was bad. But the feeling of helplessness it produced in him was even worse.
"I felt like I was being attacked by this invisible enemy," Witt says. "It was nothing that I asked for, and I didn't even know how to battle it."
So he channeled his frustration into music and art that depicted his pain. It was "a way I could express myself," he says. "It was liberating."
Witt's experience is typical of how an unpleasant sensation can become something much more complicated, scientists say.
More …
https://www.npr.org/sections/health-shots/2019/05/20/724136568/how-the-brain-shapes-pain-and-links-ouch-with-emotion
It was "this low-grade kind of menacing pain that ran through my spine and mostly my lower back and my upper right shoulder blade and then even into my neck a little bit," Witt says.
The pain was bad. But the feeling of helplessness it produced in him was even worse.
"I felt like I was being attacked by this invisible enemy," Witt says. "It was nothing that I asked for, and I didn't even know how to battle it."
So he channeled his frustration into music and art that depicted his pain. It was "a way I could express myself," he says. "It was liberating."
Witt's experience is typical of how an unpleasant sensation can become something much more complicated, scientists say.
More …
https://www.npr.org/sections/health-shots/2019/05/20/724136568/how-the-brain-shapes-pain-and-links-ouch-with-emotion
Thursday, May 16, 2019
How Tiger Woods Won the Back Surgery Lottery - The New York Times
Few would have predicted that Tiger Woods would be playing in the P.G.A. Championship this week. He had three failed back surgeries, starting in 2014. He had taken opioids. His astonishing career seemed over.
Then he had one more operation, a spinal fusion, the most complex of all, in 2017. And last month he won the Masters, playing the way he used to.
An outcome like his from fusion surgery is so rare it is "like winning the lottery," Dr. Sohail K. Mirza, a spine surgeon at Dartmouth, said.
The idea behind spinal fusion is to remove a disk — a ring of fibers filled with a nerve-cushioning jelly that joins adjacent spine bones — and fuse the spine together, a procedure that almost inevitably means trading flexibility for stability and, the patient hopes, an existence with less pain.
That was all Woods was looking for when he decided to go ahead with fusion as a last resort — a "normal life" is how he put it. He got that and much more, including a new green blazer, though the lesson that most surgeons say Woods's experience teaches isn't that fusion surgery is a panacea but how much active rehabilitation and physical therapy the procedure requires for it to work.
"If you look at it simplistically, what does fusion do? It provides mechanical support," said Dr. Charles A. Reitman, co-director of the Spine Center at the Medical University of South Carolina. "If they are missing mechanical support and that is the pure cause of the problem, then they will get better."
People with a broken spine, for example, or scoliosis, which is severe spinal curvature, or spondylolisthesis, in which vertebrae slip out of place, tend to have terrific results, he said.
But those are a tiny minority of fusion patients. The vast majority of fusion procedures are performed on patients with one or more degenerated disks, disks that are worn out, dehydrated, stiff and friable. And when those disks move, patients' backs can ache.
More ...
https://www.nytimes.com/2019/05/15/sports/how-tiger-woods-pga-back-surgery.html
Then he had one more operation, a spinal fusion, the most complex of all, in 2017. And last month he won the Masters, playing the way he used to.
An outcome like his from fusion surgery is so rare it is "like winning the lottery," Dr. Sohail K. Mirza, a spine surgeon at Dartmouth, said.
The idea behind spinal fusion is to remove a disk — a ring of fibers filled with a nerve-cushioning jelly that joins adjacent spine bones — and fuse the spine together, a procedure that almost inevitably means trading flexibility for stability and, the patient hopes, an existence with less pain.
That was all Woods was looking for when he decided to go ahead with fusion as a last resort — a "normal life" is how he put it. He got that and much more, including a new green blazer, though the lesson that most surgeons say Woods's experience teaches isn't that fusion surgery is a panacea but how much active rehabilitation and physical therapy the procedure requires for it to work.
"If you look at it simplistically, what does fusion do? It provides mechanical support," said Dr. Charles A. Reitman, co-director of the Spine Center at the Medical University of South Carolina. "If they are missing mechanical support and that is the pure cause of the problem, then they will get better."
People with a broken spine, for example, or scoliosis, which is severe spinal curvature, or spondylolisthesis, in which vertebrae slip out of place, tend to have terrific results, he said.
But those are a tiny minority of fusion patients. The vast majority of fusion procedures are performed on patients with one or more degenerated disks, disks that are worn out, dehydrated, stiff and friable. And when those disks move, patients' backs can ache.
More ...
https://www.nytimes.com/2019/05/15/sports/how-tiger-woods-pga-back-surgery.html
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