Friday, August 17, 2012

Oxygen, or lack of oxygen is involved in chronic pain pathways.

CRPSUK July Update about the Role of Oxidative Stress in Complex regional Pain Syndrome addressed the question of "whether there is a potential role for Nrf2 (activated by pharmacological or nutritional activators) in alleviating the clinical features of CRPS or preventing its progression." Nrf2 induces the expression of various genes including those that encode for several antioxidant enzymes, and it may play a physiological role in the regulation of oxidative stress. Investigational drugs that target NFE2L2 or Nrf2 are of interest as potential therapeutic interventions for oxidative-stress related pathologies.

Oxygen, or lack of oxygen is involved in chronic pain pathways. Substance p is one of many neurotransmitters involved in clinical pain syndromes such as Complex Regional Pain Syndrome. Neurotransmitters transmit information across synapses. When released neurotransmitters either help or hinder electrical impulses along nerve fibers.

Substance p's relationship with oxygen deficit is well known. Oxygen deficit triggers the release of substance p. Experiments have shown that decreasing tissue oxygen concentrations increases release of substance p. The amount of substance p is relative to the level of hypoxia or put simply, the lower the amount of oxygen, the higher the amount of substance p.

It is already known that tissue hypoxia and an increase in skin lactate levels occur in Complex Regional Pain Syndrome. Oxygen free radical scavengers (or antioxidants) such as vitamin C reduce the pain of CRPS and bring about local oxygen homeostasis, inhibiting the release of substance p. Topical capsaicin
cream (made from chilies) inhibits the release of substance p by increasing oxygen delivery. This, in essence, is merely a simplified explanation. Dr Majid Ali's Oxygen view of pain explains this well.


Dr Majid Ali recommends what he calls limbic breathing which he describes as a "vigorous type of breathing with a long out breath". My physiotherapist and my intergrative medicine doctor also recommend a the type of breathing where the out breath is longer or twice as long as the in breath. This type of breathing, I believe, activates the parasympathetic nervous system bringing about a sense of calm and thus helping us to better
cope with pain. Now I also realize that this style of breathing has the added benefit of encouraging increased oxygen intake.

For chronic pain sufferers it's important to remember to breathe.

1 comment:

Barbara Kivowitz said...

Thanks for this post. I often use different kinds of yoga breathing when I have pain. I'll try the long out-breath.

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