[HN Gopher] A built-in 'off switch' to stop persistent pain
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A built-in 'off switch' to stop persistent pain
Author : gmays
Score : 56 points
Date : 2025-10-09 20:27 UTC (2 hours ago)
(HTM) web link (penntoday.upenn.edu)
(TXT) w3m dump (penntoday.upenn.edu)
| EA-3167 wrote:
| Anyone who's experienced or knows someone who has experienced
| chronic pain appreciates how desperately the world needs a major
| breakthrough in this arena. Pain management has evolved, there
| are steady improvements, but unfortunately a lot of people are
| effectively left behind and the choice becomes a series of
| profoundly mind-altering drugs... or profoundly mind-altering
| pain. The way that pain can erode your personality and your life
| is hard to express quickly in words, but it's both invisible and
| endlessly corrosive.
|
| I certainly hope that this or another path of research leads to a
| new generation of therapies that don't depend on opioids and are
| more effective than current alternatives.
| tpmoney wrote:
| Yup. Treatment these days for chronic and severe pain amounts
| to your choice of:
|
| 1) Ever escalating doses of NSAIDs / acetaminophen and the
| associated long term health effects of that.
|
| 2) Long term opioid management which will leave you treated
| like a drug seeker by anyone who isn't your pain doctor and may
| or may not also require long term escalation and has its own
| health concerns and complicates your use of other medications.
| And god help you if you don't like your pain doctor because
| changing them is a whole different world of suspicion and poor
| treatment.
|
| 3) Various physical interventions like nerve ablations or back
| surgery or steroid injections which come with a host of other
| risks and also tend to be both expensive and temporary.
| noir_lord wrote:
| I'd love an alternative to gabapentin while accepting that it
| is what keeps me functional enough to be functional, it is for
| me a remarkable treatment except for the side effects.
| mhb wrote:
| "The current work started when Nitsan Goldstein, who was a
| graduate student in Betley's lab at the time, found that other
| urgent survival needs such as thirst and fear can also reduce
| enduring pain. That finding supported behavioral models developed
| in collaboration with the Kennedy lab at Scripps, suggest
| filtering of sensory input at the parabrachial nucleus can block
| out long-lasting pain when other more acute needs exist.
|
| "That told us the brain must have a built-in way of prioritizing
| urgent survival needs over pain, and we wanted to find the
| neurons responsible for that switch," says Goldstein."
| supportengineer wrote:
| I suffer from frequent headaches, as one way to deal with it I
| sometimes try to find something that will cause me a
| _different_ type of discomfort, such as walking several miles.
| Usually works, eventually.
| farrelle25 wrote:
| That's interesting about walking. I've done longish walking
| pilgrimages lasting several weeks (Camino etc.) and some
| stomach problems and joint problems improved a lot. I usually
| walked about 25km a day - I realise that's longer walking
| than what you mentioned.
|
| There are some books about walking putting illness into
| remission. A famous one is "The Salt Path" where someone with
| "corticobasal degeneration" brain disease was positively
| impacted by their walk. (Although the claims are in doubt now
| because the main author wasn't truthful about other aspects
| of their walk)
|
| Anyway walking probably a real positive overall!
| aspenmayer wrote:
| I wonder if more light exposure during walking is also a
| factor? Many folks don't get enough vitamin D, and light
| therapy for SAD and other conditions has shown promise as
| well. I've also noticed that 25km+ of daily backpacking for
| a few weeks continuously helped my overall fitness and
| wellness, though I don't have any chronic conditions or
| ailments at all to speak of. I do question whether many
| folks would invest the time and effort to do the work, even
| if they desire the benefits of the exertion.
| delichon wrote:
| I'd like to give an off switch for pain to every adult. Here you
| go, just turn it off if you need to. But if someone gave one to
| me I'd be in trouble, if not dead. When my back pain got severe I
| may well have killed the messenger, ignored the pain, and not
| have made the lifestyle changes that eventually gave me relief by
| fixing the problem. People with congenital insensitivity to pain
| usually have multiple damaged joints by adolescence. It's not
| very enviable.
| SadTrombone wrote:
| As someone with back pain, what were the lifestyle changes?
| maccard wrote:
| Lower or upper?
|
| Lower: lose weight, get moving, strengthen hips, glutes and
| calves.
|
| Upper: lose weight, get moving, strengthen chest, lats, core
| matt_heimer wrote:
| Core should be included in lower as well.
| SoftTalker wrote:
| Strong core is fundamental.
| kulahan wrote:
| Upper back and neck pain for me. Went to a Phys. Therapist
| and got a set of exercises. It was largely muscle weakness
| from bad posture - something many, many people will likely
| suffer in the coming years thanks to staring at screens on
| handhelds.
|
| Mine was because I have the posture of a lump of VERY wet
| clay.
|
| Also, losing weight helped a lot - less to carry around and
| hold in the right places.
| eurekin wrote:
| Prolonged sitting deconditions the gluteal muscles, and
| other muscles often compensate, which can overload them and
| alter hip/pelvic control. When tissues are strained, the
| body initiates repair via inflammation--a normal phase of
| healing. Routine NSAID use can blunt aspects of
| musculoskeletal healing in some contexts, so it's worth
| using judiciously and with clinical guidance. With reduced
| movement, fascia can lose glide and become stiffer,
| limiting mobility. Over years, chronic abnormal loading may
| contribute to osteophytes (joint margins) or enthesophytes
| (at tendon/ligament insertions). Targeted strengthening,
| mobility work, and load management from a PT typically
| help.
| ElijahLynn wrote:
| Pain Brain Film (dot com)
|
| "A documentary that follows the largest fMRI randomized
| controlled trial challenging conventional wisdom about chronic
| pain, and revolutionizing treatment for millions."
|
| Explains how these neurons get wired to fire when there is no
| physical stimulus causing the pain. Similar to phantom limb
| syndrome.
|
| There's a book called The Way Out, which documents the technique
| used in the study featured in the Pain Brain Film above.
|
| I can fully attest to this technique. It 100% works. I had
| chronic neck and back pain for 20 years. I thought it was my
| desk, I thought it was my posture, thought it was my chair. Nope,
| it was my mind.
| mhb wrote:
| Can't throw us a bone and give a hint what it is? Also, there's
| no reason not to put the actual link. Unless that's also your
| email.
| andrewmcwatters wrote:
| Pain reprocessing therapy
| Paracompact wrote:
| > The drive to look deeper into these neurons grew out of a
| simple observation Betley and his team made shortly after he
| joined Penn in 2015--hunger could dampen long-term pain
| responses. "When it came to chronic, lingering pain, hunger
| seemed to be more powerful than Advil at reducing pain."
|
| This in itself is a very interesting observation. I've always
| been inclined to fast during times of pain and anxiety, and
| honestly it kind of works? Could well be part of meditative
| fasting's popularity throughout history.
| chubot wrote:
| Yeah I fasted for the first time last year, and it pretty much
| immediately turned off a pain response due to an overactive
| immune response
|
| I got the idea from a book, and it worked
|
| When I ate again, it came back, but I was definitely relieved
| of pain for awhile. Thankfully the whole episode subsided after
| about 6 weeks, but it was comforting to know that I could turn
| it off by fasting.
| cluckindan wrote:
| The question is whether the fire is truly out, or whether the
| chronic pain is a product of socioeconomics.
| pedalpete wrote:
| This is very interesting, and I think points to the psychosomatic
| elements of pain, which is probably usually dismissed as "it's
| all in your head". But really, all pain is "in our head", it just
| tells us that the pain is elsewhere.
|
| The bigger opportunity here may be not to dismiss pain as being
| in the head, but recognizing that when it is, treating the
| suspected source is not the best route, or maybe not in
| isolation.
| solomonb wrote:
| I would be hesitant to turn off some physical pain like that of
| an injury I don't want to overextend, but for something like a
| chronic headache this would be a godsend.
|
| My most effective treatment for headaches is imitrex but you have
| to time it correctly and I really hate how it makes my body feel.
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