How Swedish research allows doctors to 'see pain'

Pain-ridden whiplash patients, overworked doctors and insurance companies are just some of the potential beneficiaries of groundbreaking Swedish research that has led to the development of a new way of “seeing” pain.

• Government to boost foreign student scholarship funding (22 Sep 11)
• Stockholm University: making an enemy of cancer (12 Sep 11)
• New generation of Arctic scientists flourish at Stockholm University (20 Jul 11)

Torsten Gordh, PhD, MD, Professor of Pain Medicine at Uppsala University Hospital and his team, and the PET center, have come up with compelling evidence of a major medical breakthrough.

In simple terms, Gordh’s team has come up with a method of pinpointing and highlighting areas of chronic pain in the body, which has previously been notoriously difficult to spot, and hence treat.

Until now doctors treating people with whiplash and other similar injuries, have more or less had to trust the patient to show them where they are in most pain and how serious it is.

“We have been working with this for seven or eight years. Originally it started when I was approached by Dr Mats Fredriksson, together with Clas Linnman, psychologists who wanted to study the effects on the brain of whiplash injuries,” Gordh tells The Local. “Our method means we can give patients a better and safer diagnosis,” he says.

In Sweden alone, patients suffering from chronic pain number some 20% of the population, or thirty five thousand people per year, while more than 50 million Americans live with chronic pain caused by various diseases or disorders, which gives some idea of the scale of the problem and the potential benefits of a solution.

While around 80 per cent of those affected are cured from their pain during the first year, the remainder will have continuous pain over many years. It is this 20% who have the most to gain from Gordh’s work. Multiply this by the number of people affected in the United States for example and you have an idea of just what a breakthrough this amounts to.

Using a form of sensor, the doctor will be able to “see” the affected area as it is highlighted. A tracer, deprenyl, is first injected into the bloodstream. The substance then groups together at the site of the pain, marking the inflammation then doctors can pinpoint the site through the use of a PET (Positron Emission Tomography) scan, rather like an x-ray for pain.

Results so far have been highly promising. The team of researchers injected the tracer into 39 volunteers, 17 of whom were free of any symptoms of pain, while 22 had prolonged neck pain after being involved in car accidents. Those patients who were suffering already showed high levels of enzyme in the area of pain
Although whiplash is perhaps the most obvious injury, the findings can be applied to several other problem areas.

“We can apply the same research to more than just whiplash injuries,” says Gordh. “For example we are working with people who have ankle joint pain, using the same tracer and then the PET and looking at longer term injuries, where people who have not got over the constant pain despite the initial damage being repaired.”

This emphasizes another less obvious side by-product of chronic pain. As most sufferers turn to drugs for treatment, the number of cases of addiction has risen considerably in recent years. At least 65,000 Swedes are estimated to be addicted to drugs, and among patients with chronic pain, it is around 3-18 percent.

This carries a high social and financial price tag. Depression, often associated with pain, and backache, are the diagnoses that account for the largest share of the costs of sickness leave in Sweden and it has been estimated that chronic pain costs Swedish society 87 billion kronor ($12 billion) per year.

Given this cost, it is perhaps of little surprise that much of the work of Fredriksson, Gordh and their team is sponsored by Swedish insurance company Länsförsäkringar. Importantly, this support has been given without any preconditions.

With the cost of insurance claims for whiplash injuries, both genuine and fraudulent, run into many millions, a more accurate way of diagnosing problems and treating them better will be of great benefit for the industry as a whole.

Although the work is still at the research stage, it is not hard to see why Gordh’s work could be so significant for so many people. Doctors will be able to make better and safer diagnoses, the cost to business and society can be considerably reduced, and perhaps most important of all, millions of chronic pain sufferers could experience a better diagnosis and treatment.

Article sponsored by Study in Sweden