In a study so simple it is a wonder it hasn’t been done before, some Chinese scientists in Xi’an have now shown that thermal hypersensitivity and mechanical hypersensitivity (touch) are not the same thing. Of course, the data from the survey at painonline has said this for years.
Chen et all have reported in Neuroscience 2006 Jan 27 that analysis of bee venom reveals four compounds capable of causing pain hypersensitization. This study was done in a peripheral nerve injury model.
These four peptides are are apamin, mast cell degranulating peptide, phospholipase A (2) (considered important in central pain–see work by Yaksh) and melittin. MDCP, PLA A (2), and melittin were able to produce ongoing pain behaviors. Only apamin and melittin produced BOTH thermal and mechanical hypersensitivity. Melattin was the most potent of the compounds. It was found that both PRE and POST treatment with capsazepine, a melittin blocker, prevented thermal but NOT mechanical hypersensitization. This little study turns out to be important in proving that all hypersensitization is NOT the same. Chemical bases exist and treatments must be devised to treat EACH of the central pains.
It is odd how frequently we get reports of central pain patients where the doctor has not bothered to take a sufficiently thorough history even to list WHICH of the central pains are present, and whether they are spontaneous or evoked. We hope articles such as this one by Chen et al, will change that. It is also too late in the day for drug companies to recommend drugs for “neuropathic pain” without going into detail as to WHICH TYPE of neuropathic pain is benefitted. Even patients sometimes refer to “neuropain” without specifying what they are talking about (it would be better to say eg. “burning dysesthesia” “lancinating pain” “muscle pain” etc), apparently not realizing how important it is to be specific. You would not get away with going to the doctor and telling her that you “don’t feel good”. She would require more specificity, and this manner of speech is important in central pain, as well. The serious lack of data which results makes it impossible to prescribe rationally and efficiently, to evaluate therapies, to decide whether or not a pump might be of benefit, or whether any type of relief at all can be expected. No matter the type of burning dysesthesia, the NIH instruction to eliminate stress as much as possible is still the best medicine. Burning dysesthesia is at the heart of severe central pain, yet it is not unusual for SCI patients with muscle or electric pains to suppose they have experienced the gamut of central pain. Since posterior column pain is nearly always treatable, it is important to know whom to encourage and whom should be cautioned about stress.
This study by Chen is once again a demonstration that the pain chemicals which evoke sensations EVERYONE accepts as real, and not psychological, are identical to some of the ones found in central pain. Could a bee sting forever? No, but burning dysesthesia can last a lifetime. Most with CP have also been stung by a bee. WE know bee stings are nothing compared to central pain. You would need an entire hive, which does not stop, to match severe burning dysesthesia.
Please see the illustration of central pain at the home page of this site. It was drawn by someone who has central pain. Two minutes staring at this picture should be plenty of time to realize that something must be done. In fact, you will find that you cannot easily look at that powerful picture for two minutes straight. The cries of pain sufferers rise against those who turn away. The country needs a priority to end pain once and for all. Instead, the governments arrest pain patients and the doctors who treat them, as if they constituted a threat to society; rather than society’s failure to commit funds to end nerve injury constituting something close to a crime against humanity. We like to say we a country ruled by law, but is that really enough. Should we not also be a country ruled by compassion?
A bee sting is a pain, not a psychological devastation. The horror movie continues. Will some scientist please get up and shut it off?