FWD:RSD In the News : FWD: RSD World News- Chronic Pain and Depression Two Separate Illnesses

RSD In the News : FWD: RSD World News- Chronic Pain and Depression Two Separate Illnesses
Choose another message board
Prev Discussion Next Discussion Delete

Reply
Recommend Delete Message 1 of 1 in Discussion

From: byrd45 (Original Message) Sent: 5/23/2005 2:27 PM
ANN ARBOR, MI -- May 5, 2005 -- Depression often causes a duet of
anguish among people already suffering from chronic pain. But the two
conditions retain their independence from one another, and this may
explain why medications used to treat patients' depression might not
help them manage their pain, a new study says.

Researchers at the University of Michigan Health System and the
University of Cologne, Germany, have used functional imaging of the
brain to determine that in patients with the chronic pain syndrome
fibromyalgia, their level of depression has little influence on the
intensity of pain they experience. This could be one of the reasons
that treating a patient's depression by prescribing an antidepressant
that has no analgesic (pain-killing) properties may have little or no
impact on their pain.

The study, in the May issue of Arthritis & Rheumatism, notes that
doctors often lump together the two conditions when they treat
patients experiencing both of them. Some 30 to 54 percent of people
with chronic pain also have a major depressive disorder.

"There is an incorrect impression among many doctors that if you treat
a patient's depression, it will make their pain better. Not so," says
Daniel J. Clauw, M.D., one of the authors of the paper. Clauw is
director of the U-M Chronic Pain and Fatigue Research Center and
professor of rheumatology at the U-M Medical School. "If someone has
pain and depression, you have to treat both."

The study involved 33 women and 20 men with fibromyalgia, a type of
chronic pain that affects several million people, more often in women
than in men, and typically involves tenderness to the touch, stiffness
and fatigue. In addition to those 53 patients, another 42 healthy
companion participants were involved in the study.

The testing included a measurement of pain experienced by subjects
based on their tolerance of pressure applied to their left thumbnails
using a hard rubber probe. Researchers also conducted interviews and
had the subjects fill out questionnaires. Using functional MRI (fMRI)
scans, researchers compared the subjects' magnitude of pain,
experimental pain sensitivity and symptoms of depression. The study
was conducted at the Georgetown University Medical Center before Clauw
and several colleagues moved to U-M.

Clauw and the other researchers found that in fibromyalgia patients,
much less pressure was required to activate the neurons associated
with acute pain in the brain's sensory domain than among the healthy
controls.

Clauw says that some other clinical research has supported the idea
that pain and depression should be treated independently from one
another. This, however, is the first time it has been shown using fMRI
brain scans.

"We have seen that if you give antidepressants to the average patient
with fibromyalgia, they'll come back a couple of months later and say,
'My pain isn't any better, but I don't feel so sad about it,' " Clauw
says. "Our research provides further evidence that these pathways are
quite independent."

While this study looked at fibromyalgia patients, it is possible that
the results may apply to people who have other chronic pain
conditions, such as low-back pain, irritable bowel syndrome and
vulvodynia, the researchers say.


SOURCE: University of Michigan Health System