Central sensitization complicates treatment of chronic pain, opioid use disorders
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Disclosure:
Clauw’s report testifies in a state lawsuit against opioid manufacturers for their role in the opioid overdose crisis.
Central sensitization may be an important underlying factor complicating the treatment of chronic pain and opioid use disorders, write the researchers in PAIN Report.
Orman Trent Hall, DOan osteopathic physician and addiction psychiatrist at Ohio State University’s Wexner Medical Center, and colleagues recruited participants with opioid use disorder (OUD) from an academic addiction treatment center in Columbus, Ohio, to assess the association between OUD and chronic pain.
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“It was important for me to find new ways to help,” Hall said in a release from the university. “But we can’t come up with better treatments for chronic pain and OUD without first understanding how the two are related. I did this research because I believe it may offer a new window into what is going on in the brains of patients who need help with pain and addiction.”
Central sensitization refers to abnormal processing of pain in the brain and spinal cord, the release states. Those with central sensitization have a spinal cord that is good at sending pain signals to the brain, and the brain often struggles to turn off those signals, suggesting that those with greater central sensitization tend to suffer more with pain than others.
Hall and colleagues enrolled a total of 141 people for the study. Study participants were electronically administered the American College of Rheumatology 2011 Fibromyalgia Survey. They also answered questions about pain disorders and quality of life, as well as items regarding pain beliefs and expectations of pain treatment and addiction.
Of all participants, 125 (88.7%) reported at least one painful body area. Pain was frequently reported in the lower back (70.2%), neck (31.9%) and upper back (30.5%). The scores of 39 participants (31.2%) were consistent with the diagnosis of fibromyalgia.
Correlational analysis showed associations between central sensitization, pain disorders and health-related quality of life among all participants. The degree of central sensitization was positively correlated with greater support of pain as a reason for the onset, maintenance and escalation of OUD; delay in treatment; and relapse.
“Our study is the first to give patients with OUD a scale that measures central sensitization,” Hall said. “Our study provides the first evidence of central sensitization underlying chronic pain and the association of OUD and demonstrates a new tool to easily measure central sensitization among individuals with OUD.”
Based on Daniel J. Clauw, MDstudy co-author and director of the Research Center for Chronic Pain and Fatigue at the University of Michigan, “Patients who were higher in central sensitization were more likely to report pain as a major reason why their opioid addiction was first initiated, as well as delaying addiction treatment, continuing and increasing opioid use. , and the fear of pain that causes OUD to recur in the future.”
Reference:
Ohio State University, Wexler Medical Center. Press release: Study provides first evidence of association between opioid use disorder, chronic pain. Published July 11, 2022. Retrieved July 12, 2022.
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