Dear Pain Matters blog readers,
Who has pain?
Here are some sobering statistics:
Moderate to severe intensity of chronic pain affects 1 in 5 (19%) adults in Europe, hence adversely impacting on the social and working lives of these chronic pain sufferers. Furthermore, 6.9% – 10% of the population suffers from nerve pain (neuropathic pain). Other studies report the incidence of nerve pain closer to 7% – 8%. In cancer, nerve pain affects 2 in 5 (39%) cancer patients with pain.
So if you suffer from nerve pain and/or chronic pain, you are certainly not alone!
Heart Rate Variability (HRV)
Given the vast numbers of nerve pain and/or chronic pain sufferers, research into heart rate variability (HRV) and its potential usefulness as an (additional) diagnostic tool for the assessment of pain intensity is warranted.
The measurement of HRV may (also) be useful to assess the effectiveness of pain treatments, ‘before‘, ‘during‘, and ‘after‘ treatments including pain medication.
Heart rate variability monitoring is non-invasive and relatively inexpensive. Real-time HRV data can even be collected in the privacy of a pain patient’s own home (via a small device) for a certain period of time (minutes, hours, or even days at a time) by the pain researcher. This data can be downloaded, and forwarded for HRV analysis at a centralized medical/research location (see papers by Litscher et al).
While selected studies involving HRV and pain are published, many more studies involving pain and HRV are needed. Research funding should be directed into HRV and nerve pain/chronic pain/acute pain/cancer pain.
There are many HRV experts including Thayer et al and Litscher et al. However, most of these HRV experts are dedicated to non pain research.
For example, an entire section in a journal called Evidence-Based Complementary and Alternative Medicine is solely dedicated to studies involving HRV. This section, called Heart Rate Variability and Complementary Medicine 2014, lists seventeen (17) HRV-related studies (see References)!
In my humble opinion, it would be nice to see a similarly long and impressive list of studies solely dedicated to HRV and nerve pain/chronic pain.
Heart rate variability monitoring in pain patients may complement current diagnostic methods including the McGill Pain Questionnaire.
Finally, comparison of HRV results ‘before‘, ‘during‘, and ‘after‘ pain treatments may offer additional insight into the effectiveness of these pain treatments including pain medication.
Master Appl. Science (Neuroscience)
With an academic interest in ‘HRV and Nerve Pain’
References for ‘Who has pain?’:
(1) Breivik et al; Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment; Eur J Pain (May 2006); 10(4), Pages 287-333.
(2) van Hecke et al; Neuropathic pain in the general population: A systematic review of epidemiological studies; Pain (April 2014); 155(4), Pages 654-662.
(3) Piano et al; Treatment for neuropathic pain in patients with cancer: comparative analysis of recommendations in national clinical practice guidelines from European countries; Pain Pract (Jan 2014); 14(1), Pages 1-7.
References for ‘Heart Rate Variability (HRV)’:
(4.0) Litscher G, He W, Yi S-H, Wang L (Guest Editors);
Heart Rate Variability and Complementary Medicine 2014 (Annual Special Issue); Evidence-Based Complementary and Alternative Medicine.
Includes the following HRV-related papers:
(4.1) Impact of Colored Light on Cardiorespiratory Coordination
(4.2) Auricular Acupressure to Improve Menstrual Pain and Menstrual Distress and Heart Rate Variability for Primary Dysmenorrhea in Youth with Stress
(4.3) The Influence of New Colored Light Stimulation Methods on Heart Rate Variability, Temperature, and Well-Being: Results of a Pilot Study in Human
(4.4) Pilot Study of Acupuncture Point Laterality: Evidence from Heart Rate Variability
(4.5) Manual Acupuncture and Laser Acupuncture for Autonomic Regulations in Rats: Observation on Heart Rate Variability and Gastric Motility
(4.6) Heart Rate Variability and Hemodynamic Change in the Superior Mesenteric Artery by Acupuncture Stimulation of Lower Limb Points: A Randomized Crossover Trial
(4.7) Effectiveness of Interstitial Laser Acupuncture Depends upon Dosage: Experimental Results from Electrocardiographic and Electrocorticographic Recordings
(4.8) Continuous Auricular Electroacupuncture Can Significantly Improve Heart Rate Variability and Clinical Scores in Patients with Depression: First Results from a Transcontinental Study
(4.9) Improvement of the Dynamic Responses of Heart Rate Variability Patterns after Needle and Laser Acupuncture Treatment in Patients with Burnout Syndrome: A Transcontinental Comparative Study
(4.10) The Physical Effects of Aromatherapy in Alleviating Work-Related Stress on Elementary School Teachers in Taiwan
(4.11) Auricular Acupuncture at the “Shenmen” and “Point Zero” Points Induced Parasympathetic Activation
(4.12) Laser Acupuncture: Two Acupoints (Baihui, Neiguan) and Two Modalities of Laser (658 nm, 405 nm) Induce Different Effects in Neurovegetative Parameters
(4.13) Effects of Acupuncture on Heart Rate Variability in Beagles; Preliminary Results, Huan Wang, Gerhard Litscher, Xian Shi, Yue Bo Jiang, and Lu Wang
(4.14) Heart Rate Variability and Complementary Medicine
(4.15) Effect of Acupuncture on Heart Rate Variability: A Systematic Review
(4.16) Intravenous Laser Blood Irradiation, Interstitial Laser Acupuncture, and Electroacupuncture in an Animal Experimental Setting: Preliminary Results from Heart Rate Variability and Electrocorticographic Recordings
(4.17) Ear Acupressure, Heart Rate, and Heart Rate Variability in Patients with Insomnia
(5.1) In English –
Analysis of Heart Rate Variability Signal
(5.2) In German –
Jens-Falk Heimann, Nicole Franke-Gricksch
Der Puls des Lebens – Die Signale des Herzens verstehen (2015; 208 pages)