How to measure pain tolerance? Researchers have developed a blood test that can assess the severity of pain, allowing for a more objective view of a currently subjective diagnosis.
Diagnosing and appropriately treating pain has always posed a challenge due to the highly subjective nature of the sensation. In an attempt to answer the question: “How to measure pain tolerance?”, researchers from Indiana University (IN, USA) have developed a blood test to identify biomarkers of pain severity and quantify the sensation.
“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,” commented study leader Alexander Niculescu. “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.”
Alongside the ability to objectively quantifiy pain, the blood test can be used to identify the most appropriate treatment option for the individual. Using a large prescription database, the markers detected in the test can be matched with existing medications or natural compounds, eliminating the unnecessary use of opioids. “The biomarker is like a fingerprint, and we match it against this database and see which compound would normalize the signature,” explained Niculescu.
"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"
This study opens the door for precision medicine in the treatment of pain, something that could be particularly beneficial in alleviating the current opioid epidemic.
“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,” Niculescu commented.
“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.”
As well as matching drugs to patients, the test can also predict whether they will experience pain in the future, a factor that could prove beneficial in determining if a patient is experiencing chronic or acute pain.
The wide variety of markers that can be present when experiencing pain make it difficult to identify a universal biomarker. “There are some markers that work better for men, some that work better for women. It could be that there are some markers that work better for headaches, some markers that work better for fibromyalgia and so on. That is where we hope to go with future larger studies,” Niculescu commented.
The team hope to personalize their approach more, moving towards clinical use. Though a self-described longshot, the work is likely to have a significant impact on the future treatment of pain.
“It’s been a goal of many researchers and a dream to find biomarkers for pain, we have come out of left field with an approach that had worked well in psychiatry for suicide and depression in previous studies. We applied it to pain, and we were successful,” concluded Niculescu.
Written By Jenny Straiton
Updated 21 May, 2019
Source Niculescu AB, Le-Niculescu H, Levey DF et al. Towards precision medicine for pain: diagnostic biomarkers and repurposed drugs. Mol. Psychiatr. doi:10.1038/s41380-018-0345-5 (2019); https://www.nature.com/articles/s41380-018-0345-5#rightslink https://medicine.iu.edu/news/2019/02/iu-school-of-medicine-makes-breakthrough-towards-developing-blood-test-for-pain/?utm_campaign=iu_news&utm_medium=web&utm_source=news.iu.edu/topic/health-and-wellness/index.html&utm_term=listing&utm_content=IU%20School%20of%20Medicine%20makes%20breakthrough%20toward%20developing%20blood%20test%20for%20pain