Targeting MS Pain

ResearchNow
Targeting MS pain contributed to peoples report of

pain intensity. The group sug-
gests that addressing pain from
a purely biomédical standpoint
P ain is a common symptom

of MS—acute pain, such as
a stabbing pain in the face, and
questions about how pain affects
people with MS by reviewing
surveys mailed to 180 people
is not enough. A biopsychoso-
cial approach—including, for
example, cognitive-behavioral
chronic pain, such as "pins and with MS. Among this group, therapy to address alarming
needles." People with MS are not 66% reported pain symptoms, thoughts about pain—would
alone—according to the Ameri- with 40.7% reporting constant better serve people with MS.
can Pain Society, pain symptoms pain during the previous four Pain 2007; 127:52-62
result in $100 billion in medical weeks. People reported pain in
bills and lost workdays each yean an average of over six areas of Pursuing new ways to stop pain
Congress declared 2001-2011 the body. Multiple Sclerosis Investigators are exploring novel
the Decade of Pain Control 2006; 12:629-38 routes for stopping MS pain; the
and Research. Let's look at this Led by Travis L. Osborne, National MS Society's Research
decade in the field of MS. PhD, this team then investi- Programs Advisory Commit-
gated psychosocial factors that tee recendy noted that efforts
The scope of pain in MS might a f e t pain (e.g., alarming to decrease MS symptoms are a
Dawn Ehde, MD, and colleagues thoughts about pain, social sup- research fijnding priority.
(University of Washington, port) in 125 of these responders. In 2005, Health Canada,
Seattle) sought answers to basic Psychosocial factors significantly the drug regulatory agency for
Canada, approved the marijuana-
derived drug Sativex {GW Phar-
maceuticals) to treat MS-related
pain. Sativex was reported to
reduce central pain (induced by
tissue damage in the brain/spinal
cord) significantly more than
inactive placebo in 66 people
with MS. Neurology 2OO5;65:
812-819 Unlike most trials of
new medications, however, inves-
tigators did not assess whether
participants knew whether they
were on study treatment or pla-
cebo, leading to some question
about the results. Sativex, which
is administered as a spray into the
mouth, is not approved for use in
Researchers funded by the National MS Society have studied the U.S.
vi/hether reflexology—massaging areas on the feet that may corre- Mark Jensen, PhD, and
spond with benefit in different parts of the body—could reduce pain colleagues (University of Wash-
in people with MS. ington) conducted a pilot study
66 Momentum • Summer.2010
combining self-hypnosis training Where pain comes from spinal cord where sensory infor-
and cognitive therapy for chronic Stephen G. Waxman, MD, PhD mation is received, including an
pain management in 15 people (Yale University), broke new influx of T cells, and increased
with MS, with funding from the ground in MS pain research, activity of brain cells (astro-
Society. Self-hypnosis involves showing the role of abnormalities cytes, microglia, macrophages)
learning how to enter a state of in sodium channels (tiny pores that play a role in the immune
focused attention and then alter along the axon that are essen- attack. Pain 2009;l4l:156-64
how one experiences pain, and tial for nerve conduction). This The team is investieatine
making these changes "auto- research led to the use of chan- immune mechanisms further to
matic." In unpublished results, nel blockers (such as phenytoin develop treatments for neuro-
participants reported significant and carbamazepine) approved pathic pain.
decreases in average daily pain for other indications to treat MS This decade has brought
and in the frequency of thoughts pain. us a better understanding of
about pain. Dr. Jensen's team is Matthew Rasband, PhD MS-related pain. People with
planning a larger study to better (Baylor College of Medicine, MS and pain should discuss
examine the benefits of self- Houston), is continuing in Dr. with their doctors options that
hypnosis. Waxman's footsteps, with fund- can help reduce this trouble-
¿'Vndrea Lowe-Strong, PhD, ing from a Harry Weaver Neuro- some symptom. Read more at
and colleagues (University of science Award from the Society. nationalMSsociety.org/
Ulster, Northern Ireland) con- He is identifying proteins that symptoms. •
ducted a study to test the effects direct the organization of ion
of reflexology—massaging areas channels, and how alterations in
on the leet that may correspond these proteins might contribute John Richert, MD
with benefit in different parts to disorganization of channels, After five years of leading
of the body—with funding and nerve pain. Such studies Research & Clinical Programs
from the Society. Dr. Lowe- might yield new treatment strate- at the National MS Society, Dr.
Strong's team randomly assigned gies more specific to MS pain. Richert has stepped down,
73 people with MS to receive Researchers also are investi- returning to one of his first
reflexology or "sham" foot mas- gating how pain evolves during loves, the development of new
sages for 10 weeks. Both groups the immune attack that damages therapies for MS. This time
experienced a 50% decrease in the brain and spinal cord in MS. he will work in partnership
pain measured by a clinical scale, Camille J. Olechowski, Brad- with the research program
along with significant decreases ley Kerr, PhD, and colleagues of a major pharmaceutical
in other symptoms, such as (University of Alberta, Edmon- firm. Please join the Society
fatigue and depression. Decreases ton) studied "allodynia" in mice staff in heartfelt thanks for
were maintained for up to 12 with MS-like EAE. Allodynia his many contributions and
weeks after completing treat- is neuropathic pain that occurs our wishes for the success of
ment. The researchers surest in response to a stimulus that his newest
that improvement in the sham should not cause pain. These endeavors
group might be due to the possi- mice developed strong allodyniu on behalf
bility that reflexology points were responses to mild cold and light of everyone
affected by the nonspecific mas- touch. The responses were asso- affected by
sage, or to a placebo effect. Mul- ciated with significant immune MS.
tiple Sclerosis 2009:15:1329-38 system activity in the area of the
nationalMSsociety.org/magazine Momentum • Summer.2010 67

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ResearchNow

Targeting MS pain contributed to peoples report of

P ain is a common symptom

nationalMSsociety.org/magazine Momentum • Summer.2010 67

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