INSITE: Chronic Pain
Research type
Research Study
Full title
INSITE: Are Pain Nerves Overactive in Chronic Pain?
IRAS ID
222438
Contact name
JP Dunham
Contact email
Sponsor organisation
University of Bristol, Reseach Governance Team
Duration of Study in the UK
3 years, 10 months, 1 days
Research summary
Chronic pain blights the lives of more than a third of all adults in the UK, with fibromyalgia affecting between 2 and 8% of the population. Unfortunately, doctors do not know why chronic pain patients, particularly those with fibromyalgia, have pain, and medications often fail to provide pain relief.
In an acute injury, specialised nerves (nociceptors) detect damage and transmit this information to the brain, which gives rise to pain. In some patients with chronic pain, including fibromyalgia, these nerves are thought to be abnormally active or "irritable". Some may be “firing” all the time, not just when damage occurs. They may also be “sensitised” so they “fire” to non-damaging events such as those that occur during normal movement or touch.
Unfortunately, we cannot detect this abnormal activity clinically, we cannot predict who has it, and we do not know what causes it. With this knowledge, we could direct currently available treatments more appropriately, optimise pain management earlier, and develop novel, targeted interventions to provide better pain relief.
Microneurography is a research technique that can directly record nociceptor activity. Whilst not suitable for routine clinical use, this approach has provided the evidence that abnormal activity in nociceptors is present in patients with chronic pain, including those with fibromyalgia.
This project will recruit patients with fibromyalgia and other chronic pain conditions. We will measure their nociceptor activity using microneurography. We will correlate this activity with clinical diagnosis, questionnaires to assess the patient experience, and careful sensory testing. This will enable us to better identify those patients with abnormal nerve activity which, in the future, will allow us to better target treatments to the cause of their pain.
REC name
South Central - Hampshire B Research Ethics Committee
REC reference
24/SC/0386
Date of REC Opinion
6 Jan 2025
REC opinion
Further Information Favourable Opinion