The Pain & Injury Doctor ONLINE Newsletter

Here is your latest pain relief tip. If it doesn’t apply to you, still take note because life is full of surprises. If you know someone who is dealing with this type of pain, please forward this email to that person– thanks!



New Model to Explain Chronic Pain

Has that painful back, hip or shoulder been with you so long that you’ve grown used to it?   Scientists have discovered another possible reason why pain sometimes does not want to go away.

If you have ongoing pain lasting six months or more following an injury, it could be related to tiny changes in the DNA of affected cells, according to new research.

First, let’s review the nature of chronic pain.

Pain is considered chronic when the injury/ damaged tissue goes through the normal stages of healing but pain remains.

The normal stages of healing involve inflammation and swelling, then tissue repair and regeneration, and lastly tissue remodeling (where it strengthens and sets in).  The first stage lasts less than a week; the second a couple of weeks depending on the severity; and the third can last for several months especially if it involves broken bones.  If things go perfectly, there is no trace of the injury:  the body’s innate wisdom does a great job of healing.

In acute pain (recently injured, recent onset), much of the pain is due to the action of inflammation (substance p, prostaglandins and others).  During swelling, the rise in internal pressure can irritate tiny sensory nerves (nociceptors) designed to emit pain signals in response to harmful stimuli (this is why during the acute phase, ice application is advised as it contracts small blood vessels which reduces swelling, and lowers temperature which slows down pain signals to the brain).

In chronic pain, the pain is more difficult to explain.  Since there is minimal to no inflammation involved, the pain, or perception of pain must have a different origin.  Recall terms such as psychosomatic pain which suggests pain manifested by thought processes; and spinal cord memory which infers a sort of “programmed” pain in the spinal cord.

Well, these are nice visual metaphors of chronic pain that make sense, but to date there is no diagnostic test to confirm these models unfortunately.

Now there is another, new finding that may explain why chronic pain exists.  Researchers from King’s College in London, England examined immune cells in the nervous system of mice and found that they changed after experiencing injury and repairing.

In the study, published in Cell Reports, they found that nerve damage changes epigenetic marks on some of the genes in these immune cells.  Epigenetics is the study in the field of genetics that examines the factors that cause certain genes to manifest their code, resulting in physical changes (called phenotype). For example, epigenetics studies why some people with a gene for cervical cancer get it, and some don’t.

The cells examined in this King’s study still behaved normally, but the presence of the epigenetic “pain” markers may mean that they carry a ‘memory’ of the initial injury.

More on the study:

Dr Franziska Denk, first author of the study, from the Wolfson Centre for Age Related Diseases at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, said: ‘We are ultimately trying to reveal why pain can turn into a chronic condition. We already knew that chronic pain patients have nerves that are more active, and we think this is probably due to various proteins and channels in those nerves having different properties.

However, it is unclear why these nerves should remain in this overactive, highly sensitive state, even when the initial injury or disease has gone: the back pain from two years ago that never quite went away or the joints that are still painful despite your rheumatoid arthritis being in remission.’

Dr Denk added: ‘We want to know why these proteins and channels should maintain their altered function over such a long period of time. Cells have housekeeping systems by which the majority of their content are replaced and renewed every few weeks and months — so why do crucial proteins keep being replaced by malfunctioning versions of themselves?  Our study is the very first step towards trying to answer this question by exploring the possibility that changes in chronic pain may persist because of epigenetics. We hope that future research in this area could help in the search for novel therapeutic targets.’

Professor Stephen McMahon from the IoPPN at King’s College London said: ‘This research raises many interesting questions: do neurons also acquire epigenetic footprints as a result of nerve injury? Do these molecular footprints affect the function of proteins? And are they ultimately the reason that chronic pain persists in patients over such long periods of time?

I think it is exciting whenever a plausible medical model is proposed to explain pain, because in medical research, this is the first, mandatory step in developing a cure.  First you identify the components responsible for the condition and then find ways to modify those components in a way that thwarts their role in producing the condition/ disease.

On the other hand, those who are suffering from chronic pain cannot wait for this research to deliver fruitful results, as it often takes  decades.   The study of neurology is frustrating in a sense, because while nerve disorders/diseases like chronic pain can be explained nicely using theoretical models, creating a cure is a much different story.  The nervous system, especially its command center– the brain– is still very much a mystery.

Dealing with Chronic Pain – Create a Health-Promoting Environment Inside and Out

If you’re suffering from chronic pain, don’t give up hope.   Do things to improve your pain that are within your control.  Cultivate an environment of healing internally (your body) and externally (your environment– your surroundings, people you associate with, your activities, your living spaces) to allow your body to maximize its healing potential.   Since it is known that the higher levels of consciousness influences severity of pain, do things that take your mind off the pain — engage in activities that are positive and uplifting and/or require your complete concentration.

If you’re taking pain relieving drugs, especially narcotics, please be aware of their side effects and addiction potential.  Check with your doctor and do some research on your own on sites like Physician’s Desk Reference, Mayo Clinic, and Dr. Mercola.

Lastly, the following are safe, non-drug home use devices I recommend you try that can be helpful for relieving chronic pain:


Is There Anything Besides Drugs for Chronic Pain?

Living With Chronic Pain – A Different Approach

Chronic Pain Affects Approximately 116 Million Americans

The information contained in this email and on is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as a medical directive. It is provided as a sharing of knowledge and information from the research and experience of Dan Perez, D.C. Every person is unique, and individual cases of pain are therefore unique. Dr. Perez encourages readers of to use available sources of information to help them make a more educated and informed decision regarding their health, in partnership with one or more qualified health care professionals. participates in the Amazon affiliate program. Any product on this website that is purchased through an Amazon affiliate link may result in a small affiliate commission to us. This revenue helps us cover the costs of producing content for this site. Thank you for your support.