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Science
CASE NOTES
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Tuesday 21:00-21:30
Repeat Wednesday 16:30
Dr Mark Porter gives listeners the low-down on what the medical profession does and doesn't know. Each week an expert in the studio tackles a particular topic and there are reports from around the UK on the health of the nation - and the NHS.
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LISTEN AGAINListen 30 min
Listen to 29 July
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DR MARK PORTER
Dr Mark Porter
PROGRAMME DETAILS
Tuesday 29 July 2008
A baby crying

Full programme transcript >>

Pain

In the first in the new series of Case Notes, Dr Mark Porter will be looking at the latest advances in the understanding of pain management.

One of the areas they're looking at is how much our state of mind affects our perception of pain – and whether techniques like distraction and relaxation can help as well as conventional pain relief.

Non-invasive scanning, that can detect tiny changes in electrical activity or blood flow within the brain without disturbing anything, makes it possible to see our brains at work.

Watching the response to painful stimuli helps Professor Irene Tracey, who's the Director of the Oxford Centre for Functional Magnetic Resonance Imaging of the brain, to see that it's a process which is far more complex that we first thought.

Pain in babies

What is the best way of telling if a newborn baby is in pain? And do premature babies experience the same sort of discomfort older children and adults do when doctors stick needles and tubes in them?

Neuroscientist Dr Rebeccah Slater and her team at University College London are trying to answer those questions.

At the moment medical teams assess whether babies are in pain from their expression - a screwed up face or bulging forehead, along with physiological signs like the heart rate.

Dr Slater used a portable machine to assess whether these signs matched up with blood flow in the brain - a sign that specific "pain centres" have been triggered.

Palliative care

Palliative care – tending to the needs of people with serious illnesses from which they will not recover – is area that has benefitted immensely from recent advances in our understanding of pain, and how to treat it.

It is a burgeoning speciality with state of the art pain management at it’s very heart.

Barbara Myers visits Martlett’s Hospice in Brighton to meet Dr Rose Turner – a Consultant in Palliative Care.

She also talks to one of the patients about how effective strong painkillers like morphine are for relieving his pain, following an operation for cancer of the oesophagus.

Dr Turner is reassuing about the use of such powerful drugs, which are not addictive when administered properly, for patients who need them.

Chronic Pain

While acute pain exists to protect us from harm by alerting us to take action against something which is harming, chronic pain caused by conditions like arthritis and sciatica may serve little useful purpose.

In fact, as Professor Tracey explains, new evidence suggests that it may actually take on a life of its own and permanently alter the nervous system.

These changes - known as 'plasticity' - are often viewed in medicine as a positive force - eg when a patient has had a stroke and areas of the brain may take over certain functions no longer carried out by other damaged areas.

But in chronic pain plasticity is viewed as a bad sign, where the pain signals remain 'switched on' and the 'volume' permanently turned up to high. Scanning such patients may provide useful information about how to treat them effectively.

Next week: health problems associated with gardening
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