Michael J Cousins AM, MD, DSc, professor and director of the Pain Management Research Institute at the University of Sydney, Royal North Shore Hospital, in Australia, presented the Decade of Pain plenary session on February 14, 2008, at the 24th Annual Meeting of the American Academy of Pain Medicine at the Gaylord Palms in Orlando, Florida.
Chronic pain is different from acute pain, explained Dr. Cousins. If pain persists despite reasonable treatment from a primary care physician and other specialists, the advice of a pain medicine specialist should be sought. The earlier such help is obtained the greater the chance of returning to a reasonable range of life activities.
According to the National Center for Health Statistics more than one-quarter of Americans (26%) age 20 years and over - or, an estimated 76.5 million Americans - report that they have had a problem with pain. Studies from the Pain Management Research Institute reveal an annual cost of $1.85 billion per 1 million people.
The Future of Pain Management In the near future, diagnosis and treatment of persistent pain will be markedly different, Dr. Cousins stated. Drugs such as morphine that provide only symptomatic relief will be replaced by or supplemented with a new generation of therapies targeted at the disease process.
The availability of new treatments may challenge the medical system. Dr. Cousins noted that too few pain medicine specialists are being trained and not enough pain patients have access to effective treatments.
Pain management needs to become a fundamental human right: a bundle of initiatives will be needed in Medicine, Law, Ethics, Politics, concluded Dr. Cousins.
Dr. Cousins also addressed the genetics of pain and brain imaging research.
Dr. Cousins has been the driving force in Australia, as well as internationally, in drawing attention to evidence that shows that severe persistent pain becomes a disease entity and has also championed the concept of pain relief as a basic human right.
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To make sure that these were still viable stem cells, the researchers transplanted them into immune-deficient mice, and measured the resulting population of various sorts of human blood and immune system cells successfully growing in the mice.
The researchers note that this finding may also lead to advances in gene therapy, in which a genetic defect would be corrected by administering a healthy version of the gene into a patient. During gene therapy, hematopoietic stem cells from a patient would be isolated and exposed to a harmless virus that expresses a correct version of the mutated gene, and then the stem cells would be transferred back into the patient.
If we could first culture stem cells such that they divide and make more stem cells before they are reintroduced into the patient, assays could be used to determine if the virus had landed in any undesirable places, in order to ensure that the healthy version of the gene is administered to the patient, says Lodish. With a technique such as this, it may be possible to ensure that the gene is inserted into the genome in the correct place.
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