Chronic Pain (cont.)
Chili peppers, capsaicin, and pain
The hot feeling, red face, and watery eyes
you experience when you bite into a red chili pepper may make you reach for a
cold drink, but that reaction has also given scientists important information
about pain. The chemical found in chili peppers that causes those feelings is
capsaicin (pronounced cap-SAY-sin), and it works its unique magic by grabbing
onto receptors scattered along the surface of sensitive nerve cells in the
mouth.
In 1997, scientists at the University of California at San Francisco
discovered a gene for a capsaicin receptor, called the vanilloid receptor. Once
in contact with capsaicin, vanilloid receptors open and pain signals are sent
from the peripheral nociceptor and through central nervous system circuits to
the brain. Investigators have also learned that this receptor plays a role in
the burning type of pain commonly associated with heat, such as the kind you
experience when you touch your finger to a hot stove. The vanilloid receptor
functions as a sort of "ouch gateway," enabling us to detect burning
hot pain, whether it originates from a 3-alarm habanera chili or from a stove
burner.
Capsaicin is currently available as a prescription or over-the-counter cream
for the treatment of a number of pain conditions, such as shingles. It works by
reducing the amount of substance P found in nerve endings and interferes with
the transmission of pain signals to the brain. Individuals can become
desensitized to the compound, however, perhaps because of long-term damage to
nerve tissue. Some individuals find the burning sensation they experience when
using capsaicin cream to be intolerable, especially when they are already
suffering from a painful condition, such as postherpetic neuralgia. Soon,
however, better treatments that relieve pain by blocking vanilloid receptors may
arrive in drugstores.
Marijuana
As a painkiller, marijuana or, by its Latin name, cannabis,
continues to remain highly controversial. In the eyes of many individuals
campaigning on its behalf, marijuana rightfully belongs with other pain
remedies. In fact, for many years, it was sold under highly controlled
conditions in cigarette form by the Federal government for just that purpose.
In 1997, the National Institutes of Health held a
workshop to discuss research on the possible therapeutic uses for smoked
marijuana. Panel members from a number of fields reviewed published research and
heard presentations from pain experts. The panel members concluded that, because
there are too few scientific studies to prove marijuana's therapeutic utility
for certain
conditions, additional research is needed. There is evidence, however, that
receptors to which marijuana binds are found in many brain regions that process
information that can produce pain.
Next: Nerve blocks »
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