Pain medicine : the official journal of the American Academy of Pain Medicine
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To identify current issues in the diagnosis and treatment of chronic pain. ⋯ There is nationwide consensus among those holding a stake in the diagnosis and treatment of chronic pain regarding the ethical issues that must be addressed. Raising awareness about chronic pain, improving access and outcomes to quality pain care, and resolving public policy debates about the use of opioids in chronic pain populations are the first steps to ensuring a morally justifiable approach to chronic pain management in the 21st century.
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We aim to determine the effects of Botulinum toxin type A (BTX-A) on neuropathic pain behavior and the expression of P2X(3) receptor in dorsal root ganglion (DRG) in rats with neuropathic pain induced by L5 ventral root transection (L5 VRT). ⋯ L5 VRT led to over-expression of P2X(3) receptors in the L5 DRG and bilateral mechanical allodynia in rats. Subcutaneous injection of BTX-A significantly reversed the neuropathic pain behavior and the over-expression of P2X(3) receptor in nociceptive neurons. These data not only show over-expression of purinergic receptors in the VRT model of neuropathic pain but also reveal a novel mechanism of botulinum toxin action on nociceptive neurons.