When we’re not feeling well—perhaps with a cold or back pain—most of us simply book an appointment with our family doctor or visit a walk-in clinic, are prescribed some medications, and start feeling better within a week or two. However, this is not the case for more than 7.6 million Canadians who suffer from chronic pain and chronic illness.
Chronic pain occurs when an individual feels pain for extended periods of time. It is often regarded as a symptom or indication of an underlying condition such as an unhealed injury. Many chronic illness patients also report experiencing chronic pain. Every year, Canadians who suffer from chronic pain and illnesses spend around $56-60 billion on treatments.
“You just feel lost in the healthcare system because you’re constantly being shuffled from one doctor to another [without a solid diagnosis],” says Loren Martin, an associate psychology professor at the University of Toronto Mississauga (UTM). His research focuses on how pain is modulated from a biological, psychological, and sociological perspective. Some of his laboratory results offer hope to patients with chronic pain.
In 2017, Professor Martin and his colleagues from McGill University and the University of North Carolina published a study in the Journal of Clinical Investigation that explored the mechanisms behind chronic pain. To do so, they recruited around 3000 to 5000 participants and followed them over a period of five years. Professor Martin and his colleagues found that those who had developed chronic pain in that time had higher levels of epiregulin, a protein that activates the epidermal growth factor receptor (EGFR) that is associated with pain.
Professor Martin notes that lung cancer patients are prescribed EGFR-inhibiting drugs that lessen pain. As part of the same study, he and his colleagues tested the EGFR inhibitor drugs on mice with chronic pain. Though the drugs reversed chronic pain in mice, using EGFR inhibitors in humans is much trickier. “These inhibitors can have various side effects,” he explains. “When given to cancer patients, it ends up [giving them] a pretty significant and painful rash.”
Medication side effects can be a patient’s worst nightmare. It isn’t enough to face difficulties from chronic pain. Now, treatment options create other issues, not to mention possible drug interactions. Some side effects can even result in personality changes linked to temper. Consequently, Professor Martin and his team have been targeting the epiregulin protein instead, which appears to have fewer side effects. It also seems to be more effective than the EGFR inhibitor. In collaboration with a pharmaceutical company, Professor Martin has developed many antibodies that keeps his research thriving.
Professor Martin developed his interest in chronic pain and its interaction with memory when he was a postdoctoral student. He states that, although memory is typically viewed as a positive thing due to enhanced learning capabilities, for pain it can be a drawback. “For chronic pain, enhanced learning communication between neurons can be bad,” explains Professor Martin. “They become hyper-responsive, and the result is enhanced pain sensitivity. Something that is normally painless now becomes perceived as painful—for instance, a touch.”
Consequently, chronic pain patients develop an increased sensitivity to acute pain. Professor Martin states that brief, happy, social interactions and reunions are enough to trigger internal pain-relieving mechanisms. In fact, one of his PhD students conducted an experiment and found that pain sensitivity significantly decreased when sibling mice reunited.
Since chronic pain isn’t life-threatening on its own, it tends to be pushed aside. However, it is serious, and it affects a large number of people. Professor Martin says that if someone experiences chronic pain for long enough, it can be life-threatening because it may lead to other illnesses including cardiovascular diseases.
Evidently, chronic pain can have enormous impacts on mental health. Anxiety, fear, and depression are far too familiar to chronic pain and chronic illness patients. Suppose you’re experiencing shoulder pain. Moving your shoulder in any way scares you, and anxiety follows.
“A lot of chronic pain [and chronic illness patients] often stop doing the things they like,” adds Professor Martin. Unfortunately, this is because they physically can no longer do certain activities. This leads to social withdrawal, which further impacts their mental health. Not to mention, patients constantly going back to the doctors without a solid diagnosis triggers mental health illnesses. “There’s this learned helplessness and hopelessness,” he continues, “Nothing’s working.”
Aside from feeling lost in the healthcare system, students who suffer from chronic pain can sometimes struggle to be taken seriously. Professor Martin explains that adults tend to advocate for themselves better than students who struggle to do so. Students advocating for themselves at school, with their doctors, or with their family can be hard—bias and stigma make it even harder.
“We need to educate professors on how to accommodate students and make them realize that not every student is trying to cheat the system,” elaborates Professor Martin. “It has been my philosophy for a while now that we must assume that if someone comes to us with a problem, [then] it’s a genuine problem. It’s a genuine illness, and it needs to be taken seriously.”
While the chance that some students who cheat the system exists, Professor Martin acknowledges that professors still help more students who actually need it. Moreover, accessibility services on campus do their best to accommodate students while ensuring that all requests are legitimate.
Professor Martin is also on the Board of Directors for the Canadian Pain Society, which is managed by researchers and clinicians. To raise awareness, they recently invited chronic pain patients as speakers and attendees at their conference. He shares that they learned so much from those patients. “If you ask a person who has lived with chronic pain what needs to be done, they say that it’s advocacy on their behalf,” he says, advising that chronic illness patients educate themselves about any potential diagnosis while being critical consumers of information.
“At the end of the day, you are the one that has your best interest at heart, and you must fight for it,” he concludes. If you suffer from chronic pain and chronic illnesses, Professor Martin encourages you to have conversations with your doctor if you believe a particular medication works for you.
Features Editor (Volume 49) | firstname.lastname@example.org —Maneka is a third year student completing a specialization in Philosophy with a minor in political science. Previously, she served as one of The Medium’s Staff Writer and Associate Features Editor. As this year’s Features Editor, Maneka hopes to raise awareness, shed light over current issues, and highlight student voices and organizations. When Maneka is not studying, writing, or working, you’ll probably find her binging on, or rather re-watching her favorite shows, listening to music, thinking about her dog, or likely taking a nap.