The Stone Pain Lab is a research laboratory at McGill University headed by Laura S Stone, PhD.

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ANALGESIC PHARMACOLOGY

Many analgesic drugs such as those acting at opioid- or alpha-2-adrenergic receptors interact in a synergistic manner when co-administered in humans or in animal models. This is important clinically as co-administration of synergistically interacting agents can help maximize analgesia while minimizing adverse side effects. We are currently investigating the hypothesis that the formation of hetero-oligomeric receptor complexes represents a molecular mechanism underlying synergy. This information may help to design safer, better tolerated and more effective pharmacological treatment strategies for chronic pain.

CHRONIC BACK PAIN

Persistent back pain is the most common chronic pain condition in Canadians age 65 and under. Unfortunately, the vast majority of individuals suffer for years with little relief. This is due, in part, to a lack of understanding of the underlying causes of back pain. We are engaged in the following preclinical and human studies designed to understand the pathophysiology of low back pain and how it can be treated.

Pre-clinical Studies

Degeneration of the intervertebral discs in the spine has been associated with increased risk of chronic low back pain. However, the relationship between disc degeneration and chronic pain is not well understood. We have developed a rodent model of back pain due to degeneration of the spine as a tool to study this phenomenon. This model will increase our understanding of the relationship between disc degeneration and pain and will allow for the identification and testing of novel therapeutic interventions for the alleviation of chronic low back pain.

Human Studies

Relationship between Intervertebral Disc Degeneration, Innervation and Low Back Pain: Pain-sensing nerve fibers are not normally observed in healthy intervertebral discs. Increases in nerve fibers within degenerating discs has been proposed as a mechanism contributing to chronic pain. In order to assess the relationship between low back pain, disc degeneration and disc innervation in humans, anatomical and biochemical studies are being performed on lumbar discs obtained surgically from chronic pain patients and post-mortem from transplant donors. These studies will help to determine if alterations in disc biochemistry or innervation may contribute to chronic low back pain.

Effect of treatment of chronic low back pain on abnormal brain anatomy and function: Chronic pain is associated with pathological changes in certain regions of the brain. The consequences of these changes are not yet fully understood, nor is it clear if they can be reversed or attenuated by successful pain management. We are using magnetic resonance imaging in chronic low back pain patients to address this question. Our data suggests that some pain-related changes in the brain can be reversed by spine surgery or spinal injections and that the extent of this reversal is correlated to decreased pain and increased physical function in patients. It is therefore possible that the brain can recover from chronic pain.

Human Biomarkers for Low Back Pain: A biological marker or biomarker is any characteristic that can be measured and evaluated as an indicator of normal biologic processes, pathologic processes or responses to therapeutic intervention. We are currently examining samples of cerebral spinal fluid (CSF) and saliva from patients with chronic low back pain for potential biomarkers using traditional biochemical and cutting edge proteomics methods (i.e. LC-MS/MS). The identification of biomarkers for chronic low back pain will provide insight into its diagnosis and treatment.