Around 100 million people in America alone are in pain right now, and 1 in 5 in Australia. But, how much pain exactly? Scientists and pain experts have been searching for a way to be able to quantify this question. Now, they are closer than ever before to having a method. The remarkable thing is, it is just a simple blood test. Further research is needed to bring this idea out to actual use, but it will be a quick and cost-effective way for doctors to determine the severity of pain.
Two Peas In A Pod
This blood test for pain will work wonders for patients with migraine, cancer pain, fibromyalgia, and lower back pain, for example. They hope that this test will revolutionize the diagnosis and treatment of people around the world living with chronic pain, as well as help curb the opioids epidemic.
In Australia, there is neuroscientist Professor Mark Hutchinson who has developed the world-first test with an Australian-based team focused on helping those who suffer chronic pain. In America, a study led by psychiatry professor Alexander Niculescu, MD, PhD at Indiana University School of Medicine was conducted to catalogue pain biomarkers so physicians can better treat patients with precision medicine, and help stem the tide of the opioid crisis.
Hutchinson’s team created a test (called PainHS) which uses light measurement tools known as hyperspectral imaging analysis to identify molecular structures of what pain looks like in blood cells. It is an on-the-spot blood test that identifies chronic pain by color “biomarkers”.
“We are literally quantifying the color of pain. We’ve now discovered that we can use the natural color of biology to predict the severity of pain,” he continued. “What we’ve found is that persistent chronic pain has a different natural color in immune cells than in a situation where there isn’t persistent pain.”
This test would be especially beneficial for treating patients who are nonverbal, like babies, people with dementia, or people in intensive care who can’t communicate the degree of pain they’re in. Pain assessment relies on a patient’s own report of their experience. Obviously, it is difficult to determine the severity of a patient’s pain if they can not tell their report.
It will also be helpful for patients who really do suffer from a lot of pain but are not taken seriously because the physician is worried they may be drug seekers. Many patients suffer hugely from discrimination and people treating them very rudely, but if there was a test to gauge their pain, this sort of thing would not happen. This test would facilitate in directing therapy and validating what the patient is telling their doctor. It will then allow people experiencing chronic pain to be accepted by the mainstream medical profession, by colleagues in other disciplines, and by the community more broadly.
“If they say they’re in pain and if the doctor doesn’t believe them for whatever reason, there may be tests, our tests and other tests, in the future that could be run on these patients. That’s great for the patient, because patients that know they’re in pain are heard and validated.”
Some doubt this new test will be a game changer for the way a doctor assesses pain because an individual’s perception of pain is highly subjective. People actively construct the perception of pain and continually reevaluate what they see themselves to be experiencing. What this means is that a patient may feel like they are in more pain than the blood test reveals because they have built it up in their mind to be something greater than it is. Unfortunately for the individual, what they think they are feeling is what they will feel but the test will not match.
Indiana University School of Medicine
Hundreds of individuals at the Richard L. Roudebush VA Medical Center in Indianapolis participated in this study. Their blood was analyzed to identify any biomarkers in the blood that can help objectively determine how severe a patient’s pain is. The researchers looked at the biomarkers found in the blood — in this case, molecules that reflect disease severity. This approach can be compared to how glucose serves as a biomarker to diabetes. They published the results in the Nature journal Molecular Psychiatry.
Niculescu, who worked with other Department of Psychiatry researchers on the study, said:
“We have developed a prototype for a blood test that can objectively tell doctors if the patient is in pain, and how severe that pain is. It’s very important to have an objective measure of pain, as pain is a subjective sensation. Until now we have had to rely on patients self-reporting or the clinical impression the doctor has. When we started this work it was a farfetched idea. But the idea was to find a way to treat and prescribe things more appropriately to people who are in pain.”
Not only would a blood test for pain enable physicians to treat pain far more accurately, but it would also contribute to a better long-term look at the patient’s medical future. Furthermore, with an opioid epidemic raging throughout the United States, now more than ever before, the administration of drugs needs to be executed responsibly and accurately.
“The opioid epidemic occurred because addictive medications were overprescribed due to the fact that there was no objective measure whether someone was in pain, or how severe their pain was. Before, doctors weren’t being taught good alternatives. The thought was that this person says they are in pain, let’s prescribe it. Now people are seeing that this created a huge problem. We need alternatives to opioids, and we need to treat people in a precise fashion. This test we’ve developed allows for that.”
The blood test can further help by matching the biomarkers in the patient’s blood with potential treatment options. Once the test determines which biomarkers are in the blood, and how many, the doctor can match the pain biomarkers with profiles of drugs and natural compounds catalogued in the prescription database. In this sense, the biomarker is like a fingerprint says Niculescu.
“The biomarker is like a fingerprint, and we match it against this database and see which compound would normalize the signature. We found some compounds that have been used for decades to treat other things pair the best with the biomarkers. We have been able to match biomarkers with existing medications, or natural compounds, which would reduce or eliminate the need to use the opioids. In any field, the goal is to match the patient to the right drug, which hopefully does a lot of good and very little harm. But through precision health, by having lots of options geared toward the needs of specific patients, you prevent larger problems, like the opioid epidemic, from occurring.”
The advantage of precision medicine is that a doctor can give a patient treatment that is tailored directly to them and their needs. Niculescu’s team has already found some markers for pain that are universal. They have also found that there are some markers that work better for men, and some that work better for women.
Now, what they hope to find in future larger studies, is if there are some markers that work better for headaches, some markers that work better for fibromyalgia, and so on. When they figure this out, doctors will be able to prescribe an exact dose of the perfect matching medicine to the exact kind of pain a person is experiencing.