University of Arizona pharmacologists are studying the underlying molecular causes of post-surgery pain, with hopes of developing treatments that prevent such chronic pain from developing at all.
Awarded a four-year, $1.1 million grant from the National Institutes of Health, professors Gregory O. Dussor and Theodore J. Price in the UA College of Medicine are investigating how the signal pathways that are activated during surgery can be manipulated to prevent the onset of chronic pain.
"Surgery has the major advantage that you know exactly when it is going to happen and something can be done about inhibiting these pathways at the time of injury," Price said.
Essentially, the researchers are working on a cellular short circuit that will prevent the pain from developing.
"Just about everybody will have surgery during their lifetime. It's really like taking a prophylactic to prevent the development of chronic pain," Price says. "That's a huge mount of human suffering that could be avoided. We're trying to make the argument from a clinical standpoint that there's something cheap and safe that can dramatically reduce the burden on chronic pain patients."
Some of the most common surgeries, like chest operations and mastectomies, are the ones that cause the highest rates of chronic post-surgery pain.
"Any patients can have long term neuropathic pain brought about by surgery," Dussor said. "There are examples of that lasting a long time."
There are a number of drugs clinically available right now that can be options for inhibiting the pain pathways.
Pre-clinical evidence exists that metformin, an antidiabetic medicine that's one of the most prescribed drugs in the world, works very well for this, Dussor and Price say.
"However, it's not the most potent activator," Price said. "What we're trying to do is look at local treatment with more potent compounds that could be applied through injection locally."
"We need to validate the mechanism and do more investigation into the signaling pathways involved in promoting chronic post surgical pain," he said.
Dussor and Price say their overlapping expertise and the College of Medicine's interdisciplinary structure are what allow this collaborative research to thrive.
"We have a big pain research group here which makes it easy to have discussions about what are the major clinical questions that need to be addressed and that’s led us in this direction," Price said.