Transcript Dr. Al-Chaer: “Pain: The Paradox of Research

Center for Translational Neuroscience
Distinguished Speaker Series
Rayford Auditorium, Biomed II Bldg.
Tuesday, September 25, 12 noon
“Pain: The Paradox of Research Advances and Clinical Retreats”
Elie D. Al-Chaer, PhD, JD
Associate Professor of Pediatrics, Medicine and Neurobiology
Center for Pain Research
“Functional Pain: Fiction, Function or Dysfunction”
Alice V. Fann, MD, PhD
Staff physician of physical medicine and rehabilitation at
John L. McClellan Memorial Veterans Administration Medical Center
University of Arkansas for Medical Sciences
Little Rock, AR
Alice V. Fann, MD: “Functional Pain: Fiction, Function or Dysfunction”
Fibromyalgia, irritable bowel syndrome (IBS) and other functional pain disorders are commonly
misunderstood and remain controversial diagnoses among physicians. These disorders are
similar group of syndromes without structural pathology, but are thought to be bound by the
mechanism of central sensitization. This seminar will review the symptoms, diagnoses,
treatment and known and theorized mechanisms for these disorders.
Elie D. Al-Chaer, PhD, JD: “Pain: The Paradox of Research Advances and Clinical Retreat”
Our fascination with pain mechanisms possibly dates back to our awareness of our existence.
Yet our study of pain pathways only gained focus with the reflex theory advanced by René
Descartes in 1664 and was rejuvenated time and again by a number of subsequent theories.
Despite that, our understanding of visceral pain and its mechanisms lagged behind due to the
lack of a valid animal model. This presentation concisely highlights breakthrough advances made
in an animal model of neonatal injury, defining the mechanisms of visceral pain in different levels
of the nervous system.
These breakthroughs in defining pain mechanisms and pathways have advanced the field of
pain research and management particularly in the areas of drug development. However, despite
these extraordinarily impressive scientific advances in our understanding of the mechanisms of
pain and describing some of its pathways, the field is beset by similarly and equally impressive
stalemates and retreats in the actual management and cure of pain. After all, knowledge about
pain and its mechanisms is only useful to the extent it helps the sufferer.
For pain relief, we naturally use anything that works; historically we used trephination, opiates
and willow bark. Today, regardless of their site of action, we continue to use some of the same
techniques that worked albeit in different pharmaceutical formulae and more controlled
environments… but the nervous system seems to be extremely resistant to switching off pain!