Oro-facial pain and headache: Oro-facial pain and headache are among the most common and the most problematic pain syndromes known. Pharmacological and neuropathological research on severe migraine and tension headaches, trigeminal and glossopharyngeal neuralgia, and chronic atypical oro-facial pain are among the projects currently active in the center.
Novel analgesic drugs: Biochemical and pharmacological research work in the Center is aimed at improving the effectiveness of existing analgesic drugs, and finding new ones. For example, Prof. Florella Magora and colleagues developed many years ago a novel way of administering morphine (epidurally). This method is now in routine use worldwide. An approach currently under investigation is based on the knowledge that the brain employs neural peptides and morphine-like substances to modulate pain signals. Derivatives of these molecules can be used to mimic and augment the brain’s own pain modulation capability. Another group of molecules presently under study are derivatives of cannabis. The aim is to exploit pain relieving properties of cannabinoids while avoiding their psychogenic side-effects. Likewise, molecules that block the membrane channels responsible for the electrical excitability of neurons hold out promise as novel analgesics, as do molecule that interact with key receptors in the pain system.
Nerve injury (neuropathic pain): A broad spectrum of common and highly debilitating conditions are related to injury, irritation and inflammation of nerves and nerve endings. This include CNS neurophysiological, neurochemical and neuroanatomical changes triggered by nerve damage are being studied with the aim of understanding the basic biological processes by which injured nerves become hyperexcitable. Such knowledge is essential for the development of new classes of drugs and novel pain management techniques. One such technique, transcutaneous electrical nerve stimulation (TENS), was developed by a leading member of the center and is now in use in pain clinics around the world.
Pain and the immune system: Neuropsychological studies by members of the Pain Center have contributed to a new awareness of links between pain, stress and the immune system. Not only is chronic pain a source of individual suffering, but it weakens the ability of the body to fight off other diseases, including cancer. Likewise, substances produced by the body in its fight against disease appear to contribute directly to feelings of illness and discomfort. Mechanisms whereby stress compromises the immune system, and identification of the molecules that mediate the interactions between pain and the immune system are under intensive study in the center.
Behavioral models, diet, and inherited predisposition to pain: One of the main limitations on current pain research efforts is the paucity of good experimental models that mimic chronic pain syndromes in man. Center investigators are actively engaged in designing new models and testing their relevance to clinical entities. Center investigators have recently exploited two models, that were developed in the center some years ago, to show that constituents of the diet that animals are fed can influence the development of chronic pain symptoms. Likewise, animal models have been used to provide the first experimental evidence that the degree of susceptibility to some chronic neuropathic pains may be inherited. Genetic determinants of chronic pain susceptibility are now being pursued in the center both in model systems and in populations of chronic pain patients. Genetics may help to explain why some individuals with nerve injury develop chronic pain while others, with the identical injury, do not.
Treatment and rehabilitation: Prominent among the center’s aims is the generation and dissemination of knowledge that will improve the treatment and rehabilitation of pain patients. Physicians in the center are responsible for the operation of medical services at affiliated in- and outpatient clinics. These include a general Pain Clinic, and specialty clinics that focus on head pain, rehabilitation daycare, and reflex sympathetic dystrophy. The clinics also serve as a venue where research workers can obtain firsthand contact with the pain syndromes they are investigating in laboratory models. The Pain Center fosters consultation among its members in an attempt to find alternatives for patients who have failed to respond to conventional therapy.Education and awareness: Beyond its academic and medical role, the Pain Center endeavors to disseminate information on the current state of knowledge in the field, and on the need to learn more. The center helped found, and remains a major contributor to, the Israel Pain Association (IPA), the Israeli chapter of the International Association for the Study of Pain (IASP). As such it participates in the arrangement of symposia and conferences, the hosting of foreign visitors, the generation of educational publications in English and in Hebrew, and the representation of the Israeli pain research community in the international arena.