A study in this month’s Anesthesia & Analgesics journal suggests that phantom limb pain, pain often experienced by amputees that’s perceived to be in a missing limb, can be alleviated by mirror therapy. Researchers at the Naval Medical Center in San Diego say they were able to reduce phantom pain in some soldiers via this form of therapy in which patients sit with a mirror vertically between their legs and arms so that the limbs are reflected in it. The reflection in the mirror makes it appear like the injured arm or leg is healthy and normal. The theory behind phantom limb pain is that the pain pathways in the brain and spinal cord can recall the traumatic injury, thus the missing limb somehow continues to hurt, despite not being there anymore. In performing mirror therapy, the brain and spinal cord are visually tricked into believing that all of the person’s limbs are intact and without pain, thus reducing brain activity associated with pain and modulating the pain response experienced by the amputee. [via BusinessWeek]
Photophobia, the fear of light, is a common complaint seen in patients during a migraine attack. Until now, the association between light and migraine headaches was not completely understood. In the current issue of Nature Neuroscience, scientists report the discovery of a new pathway leading from the optic nerves in the eyes (the nerves responsible for vision) to the brain areas where neurons that are active during migraine attacks reside. During a migraine, light can increase the electrical activity of these neurons and lead to an increased intensity of the headache. Although this discovery alone will probably not lead to any immediate new interventions for migraine sufferers, it does provide us with physiologic evidence that photophobia is a real and exacerbating factor for migraine sufferers. [via HealthDay]
It appears that the human nervous system is more complex than we know. In addition to the nerves in our skin that allow us to feel pressure, vibration, temperature and pain a fine network of nerves associated with small blood vessels and sweat glands appear to have the same functional abilities. It was previously believed that these nerves simply regulated blood flow and sweating. However, by studying people who were born without conventional nerve endings in their skin, scientists realized that even though their skin sensations were severely diminished, they still had adequate sensation for daily living. “Apparently, these unique individuals are able to ‘feel things’ through these remaining nerve endings. What we learned from these unusual individuals is that there’s another level of sensory feedback that can give us conscious tactile information”, said Dr. Frank Rice, a neuroscience professor at Albany Medical College. The study is published in the December 15 issue of the journal Pain. Could these nerves be associated with pain-related conditions such as migraines and fibromyalgia? Only time will tell. [via Science Daily]
Dr. Bahman Guyuron, Chair of Plastic Surgery at University Hospitals Case Medical Center and Case Western Reserve University School of Medicine noted a decade ago that many patients who underwent forehead rejuvenation saw a disappearance in migraine symptoms after surgery. It was this astute observation which gave him the idea to use surgery as a means to alleviate the pain of migraines. By detecting superficial trigger sites on the muscles of the head and then removing or diminishing their affects on nerves, Dr. Guyuron has shown strong evidence that surgical manipulation of one or more migraine trigger sites can successfully eliminate or reduce the frequency, duration, and/or intensity of migraine headaches with lasting results. [via Science Daily]
Stanford University researchers have found that regions with high concentrations of MRI machines also have increased rates of back surgery among patients who present with new back pain. Is there a problem with this? Well, perhaps, especially since we know that increased surgery rates doesn’t necessarily improve patient outcome. In fact, surgery has its risks and often times will not completely cure back pain. Between 2000 and 2005, the MRI availability in the U.S. more than tripled, from 7.6 to 26.6 machines per 1 million people. Each machine costs more than $2 million and one low-back scan costs $1,500. Increased rates of scans and surgeries increase the total health care dollars spent on treatment of back pain, one of the most common reasons for physician visits today. [via Medical News Today]
Dr. Steven Chang, the author of DailyDose, is a staff physician with Kosmix RightHealth. Dr. Chang practices Family Medicine at the University of California Davis Medical Center, where his medical interests include both pediatric and geriatric care, public health, gay and lesbian health, and sleep medicine. Dr. Chang trained at the Stanford University affiliated O'Connor Hospital, and was a research fellow at the National Institute of Health. He holds an M.D. from McGill University and a BA in Public Health from Johns Hopkins University.
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Dr. Steven Chang, the author of DailyDose, is a staff physician with Kosmix RightHealth. Dr. Chang practices Family Medicine at the University of California Davis Medical Center, where his medical interests include both pediatric and geriatric care, public health, gay and lesbian health, and sleep medicine. Dr. Chang trained at the Stanford University affiliated O'Connor Hospital, and was a research fellow at the National Institute of Health. He holds an M.D. from McGill University and a BA in Public Health from Johns Hopkins University.