Sodium channels Blockers Role in pain management?
The new injections ( The Anatomical Gates Of Heaven)
How can an injection given peripherally relieve pain when the cause of pain is more proximal?
How can a simple Lidocaine injection effect last for months when the half life of Lignocaine is only around one hour?
To understand that we have to understand the following:
1/ The role of Dorsal Root Ganglion in pain( DRG)
2/ The role of Sodium Channels in nerve function and pain
1/ The Role of DRG in pain: (1)
DRG neurons have two branches that act as a single axon, a distal process and a proximal process, connected by a cell body as an offshoot, they are called pseudounipolar neurons to differentiate them from bipolar cells
A pseuodunipolar sensory neuron. A pseudounipolar neuron has one axon that is divided into two separate branches, one from the periphery to the body and one from the body to the spinal cord.
Because DRG neurons have two branches that act as a single axon, a distal process and a proximal process, connected by a cell body as an offshoot, they are called pseudounipolar neurons to differentiate them from bipolar cells, where the body is intersperced between two axons.
Because it is anatomically and physically accessible to clinical interventions for the control of peripheral acute and chronic pain, and, as we shall see in this review, the dorsal root ganglia (DRG) has an integral and important role in the modulation of peripheral and central sensory processing that includes inflammation, somatic pain, and the development of aberrant, neuropathic pain (NP), the DRG is an excellent clinical target for pain control, both from outside of the neural foramina into the epidural space and from the epidural space to the outside through the neural foramina. The DRG, in fact, is a known clinical target for the delivery of anti-inflammatory steroids , for surgery (ganglionectomy) , for radio-frequency ablation , for pulsed-radio frequency ,and for electrical neuromodulation therapies. In fact, recent literature supports the notion that electrical stimulation of the DRG reduces pain states
Because the DRG is not protected by a blood nerve barrier, small and large molecules and even macrophages can cross the SGC wrap of the DRG neuron
2/ The role of Sodium Channels in nerve function and pain
After nerve injury hyperexcitability and spontaneous firing develop at the site of injury and also in the dorsal root ganglion cell bodies. This hyperexcitability results at least partly from accumulation of sodium channels at the site of injury. (2)
pain is related to excited nerves and disturbance in Sodium Channels.
Simply by giving Lignocaine which is a Sodium Channel Blocker you are resetting the Electricity of nerves like resetting a jammed laptop
We expect many studies will be conducted in the forthcoming decades to better understand the Sodium Channels and their relationship to nerve function.
These injections prove that the cause of pain in disc disease is neither Mechanical nor Chemical but rather disturbance in Sodium Channels.