Welcome!
PAIN PROGRAM
A typical visit to the Headache and Pain clinic involves initial evaluation by a neurologist to establish the proper diagnosis and to provide the latest advanced management for headache and pain conditions. Complicated cases may require a multidisciplinary approach with affiliated psychologists, physical therapists, and anesthesiologists to provide the best effective treatment for headache and pain. The treatment options after establishing the diagnosis are medication adjustments, nerve block, botox injection, and occasionally surgical intervention.
Treatment of chronic pain remains a major weakness of modern medicine. While great advances have been made in providing relief from acute traumatic and post-operative pain, treatment of chronic, unremitting pain, whether from injury or inflammation, has largely been a dismal failure. In spite of expanding knowledge about neurotransmitters and neuro-modulators that convey nociceptive (painful) information and the existence of several animal models which mimic the characteristics of human chronic pain syndromes, the pathophysiology underlying development of chronic pain has yet to be elucidated. M. Maher Fakhouri, MD is a clinical specialist in headache and pain management.
Joshua Adler, MD, PhD also specializes in neuropathic pain. His laboratory has long been devoted to the study of neuropathic pain, its etiology, pathophysiology and relief potential. We have reported that in an animal model of such pain, there as is an abnormal redistribution of nociceptive neuropeptides within the spinal cord to areas where they are not normally expressed. This redistribution, apparently induced by inflammatory cytokines and neurotrophic factors, may be the underlying abnormality that induces chronic pain. We are currently investigating pathophysiologic mechanisms underlying abnormal distribution after trauma. At the same time, we are investigating novel methods for preventing pain after nerve injury. By binding specific trophic factors, which have analgesic properties, to synthetic scaffolding on which nerves can grow, we can prevent the development of neuropathic pain. This work has major implications with regard to treatment and may help prevent the late occurrence of pain after injury.
