Please ensure Javascript is enabled for purposes of website accessibility

West Bank Town Becomes ‘Big Prison’ as Israel Fences It In

1 day ago

Trump Says He’s Willing to Let Migrant Farm Laborers Stay in US

1 day ago

US Electric Vehicle Tax Breaks Will Expire on Sept. 30

2 days ago

Eyeing Arctic Dominance, Trump Bill Earmarks $8.6 Billion for US Coast Guard Icebreakers

2 days ago

Trump’s Sweeping Tax-Cut and Spending Bill Wins Congressional Approval

2 days ago

Americans Celebrate Their Independence With Record-Breaking Travel Numbers

2 days ago

US Supreme Court to Decide Legality of Transgender School Sports Bans

2 days ago

Nvidia Set to Become the World’s Most Valuable Company in History

2 days ago

Poll: 41% in US ‘Extremely Proud’ to Be American, Near Historic Low

2 days ago
No Stethoscope for Pain: Scientists Seek Real Way to Measure
gvw_ap_news
By Associated Press
Published 6 years ago on
January 12, 2019

Share

WASHINGTON — Is the pain stabbing or burning? On a scale from 1 to 10, is it a 6 or an 8?
Over and over, 17-year-old Sarah Taylor struggled to make doctors understand her sometimes debilitating levels of pain, first from joint-damaging childhood arthritis and then from fibromyalgia.

“It’s really hard when people can’t see how much pain you’re in, because they have to take your word on it and sometimes, they don’t quite believe you.” — 17-year-old Sarah Taylor
“It’s really hard when people can’t see how much pain you’re in, because they have to take your word on it and sometimes, they don’t quite believe you,” she said.
Now scientists are peeking into Sarah’s eyes to track how her pupils react when she’s hurting and when she’s not — part of a quest to develop the first objective way to measure pain.
“If we can’t measure pain, we can’t fix it,” said Dr. Julia Finkel, a pediatric anesthesiologist at Children’s National Medical Center in Washington, who invented the experimental eye-tracking device.
At just about every doctor’s visit you’ll get your temperature, heart rate and blood pressure measured. But there’s no stethoscope for pain. Patients must convey how bad it is using that 10-point scale or emoji-style charts that show faces turning from smiles to frowns.
That’s problematic for lots of reasons. Doctors and nurses have to guess at babies’ pain by their cries and squirms, for example. The aching that one person rates a 7 might be a 4 to someone who’s more used to serious pain or genetically more tolerant. Patient-to-patient variability makes it hard to test if potential new painkillers really work.

Scientists Have Begun Studies of Brain Scans and Pupil Reactions

Nor do self-ratings determine what kind of pain someone has — one reason for trial-and-error treatment. Are opioids necessary? Or is the pain, like Sarah’s, better suited to nerve-targeting medicines?

“It’s very frustrating to be in pain and you have to wait like six weeks, two months, to see if the drug’s working.” — 17-year-old Sarah Taylor
“It’s very frustrating to be in pain and you have to wait like six weeks, two months, to see if the drug’s working,” said Sarah, who uses a combination of medications, acupuncture and lots of exercise to counter her pain.
The National Institutes of Health is pushing for development of what its director, Dr. Francis Collins, has called a “pain-o-meter.” Spurred by the opioid crisis , the goal isn’t just to signal how much pain someone’s in. It’s also to determine what kind it is and what drug might be the most effective.
“We’re not creating a lie detector for pain,” stressed David Thomas of NIH’s National Institute on Drug Abuse, who oversees the research. “We do not want to lose the patient voice.”
Around the country, NIH-funded scientists have begun studies of brain scans, pupil reactions and other possible markers of pain in hopes of finally “seeing” the ouch so they can better treat it. It’s early-stage research, and it’s not clear how soon any of the attempts might pan out.
“There won’t be a single signature of pain,” Thomas predicted. “My vision is that someday we’ll pull these different metrics together for something of a fingerprint of pain.”
Acupuncture needles are applied on Sarah Taylor's back during an acupuncture treatment at the Children's National Medical Center in Washington
Acupuncture needles are applied on Sarah Taylor’s back during an acupuncture treatment at the Children’s National Medical Center in Washington, Monday, Dec. 10, 2018. Over and over, the 17-year-old struggled to make doctors understand her sometimes debilitating levels of pain, first from joint-damaging childhood arthritis and then from fibromyalgia. “It’s very frustrating to be in pain and you have to wait like six weeks, two months, to see if the drug’s working,” said Sarah, who uses a combination of medications, acupuncture and lots of exercise to counter her pain. Children’s National Medical Center is testing an experimental device that aims to measure pain according to how pupils react to certain stimuli. (AP Photo/Manuel Balce Ceneta)

25 Million People in the U.S. Experience Daily Pain

NIH estimates 25 million people in the U.S. experience daily pain. Most days Sarah Taylor is one of them. Now living in Potomac, Maryland, she was a toddler in her native Australia when the swollen, aching joints of juvenile arthritis appeared. She’s had migraines and spinal inflammation. Then two years ago, the body-wide pain of fibromyalgia struck; a flare-up last winter hospitalized her for two weeks.
One recent morning, Sarah climbed onto an acupuncture table at Children’s National, rated that day’s pain a not-too-bad 3, and opened her eyes wide for the experimental pain test.
“There’ll be a flash of light for 10 seconds. All you have to do is try not to blink,” researcher Kevin Jackson told Sarah as he lined up the pupil-tracking device, mounted on a smartphone.
The eyes offer a window to pain centers in the brain, said Finkel, who directs pain research at Children’s Sheikh Zayed Institute for Pediatric Surgical Innovation.
How? Some pain-sensing nerves transmit “ouch” signals to the brain along pathways that also alter muscles of the pupils as they react to different stimuli. Finkel’s device tracks pupillary reactions to light or to non-painful stimulation of certain nerve fibers, aiming to link different patterns to different intensities and types of pain.
Consider the shooting hip and leg pain of sciatica: “Everyone knows someone who’s been started on oxycodone for their sciatic nerve pain. And they’ll tell you that they feel it — it still hurts — and they just don’t care,” Finkel said.

MRI Scans Revealed Patterns of Inflammation in the Brain

What’s going on? An opioid like oxycodone brings some relief by dulling the perception of pain but not its transmission — while a different kind of drug might block the pain by targeting the culprit nerve fiber, she said.

“Your brain changes with pain. A zero-to-10 scale or a happy-face scale doesn’t capture anywhere near the totality of the pain experience.” — David Thomas of NIH’s National Institute on Drug Abuse
Certain medications also can be detected by other changes in a resting pupil, she said. Last month the Food and Drug Administration announced it would help AlgometRx, a biotech company Finkel founded, speed development of the device as a rapid drug screen.
Looking deeper than the eyes, scientists at Harvard and Massachusetts General Hospital found MRI scans revealed patterns of inflammation in the brain that identified either fibromyalgia or chronic back pain.
Other researchers have found changes in brain activity — where different areas “light up” on scans — that signal certain types of pain. Still others are using electrodes on the scalp to measure pain through brain waves.
Ultimately, NIH wants to uncover biological markers that explain why some people recover from acute pain while others develop hard-to-treat chronic pain.
“Your brain changes with pain,” Thomas explained. “A zero-to-10 scale or a happy-face scale doesn’t capture anywhere near the totality of the pain experience.”

DON'T MISS

What Are Fresno Real Estate Experts Predicting for 2025 and Beyond?

DON'T MISS

First California EV Mandates Hit Automakers This Year. Most Are Not Even Close

DON'T MISS

How Trump’s ‘Big, Beautiful Bill’ Will Make China Great Again

DON'T MISS

What’s Caitlin Clark Worth to the WNBA? A Lot More Than Her $78,066 Salary.

DON'T MISS

Trump to Sign Tax-Cut and Spending Bill in July 4 Ceremony

DON'T MISS

Madre Fire Spurs Evacuations Across 3 Counties, Grows to More Than 70,000 Acres

DON'T MISS

Clovis, Sanger, Madera, and Bass Lake Will Light the Sky With Fireworks Shows Tonight

DON'T MISS

Oil Dips Ahead of Expected OPEC+ Output Increase

DON'T MISS

613 Killed at Gaza Aid Distribution Sites, Near Humanitarian Covoys, Says UN

DON'T MISS

Fresno County Authorities Investigating Suspicious Death of Transient Man

DON'T MISS

West Bank Town Becomes ‘Big Prison’ as Israel Fences It In

DON'T MISS

Israeli Military Kills 20 in Gaza as Trump Awaits Hamas Reply to Truce Proposal

UP NEXT

Americans Celebrate Their Independence With Record-Breaking Travel Numbers

UP NEXT

Poll: 41% in US ‘Extremely Proud’ to Be American, Near Historic Low

UP NEXT

Poorest Americans Dealt Biggest Blow Under Senate Republican Tax Package

UP NEXT

Poll: Most Americans Say National Divide, Political Violence Threaten Democracy

UP NEXT

Trump Pulls Back 150 Guard Troops From Federal Duties in California

UP NEXT

Suspect Identified in Ambush Shooting That Killed 2 Idaho Firefighters

UP NEXT

Suspect Identified in Ambush Shooting That Killed 2 Idaho Firefighters

UP NEXT

US Supreme Court Lets Parents Take Kids Out of Classes With LGBT Storybooks

UP NEXT

Bill Moyers, Broadcaster and LBJ’s White House Press Secretary, Dies at 91

UP NEXT

Tesla Executive, Elon Musk Confidant Leaves EV Maker, Bloomberg News Reports

Madre Fire Spurs Evacuations Across 3 Counties, Grows to More Than 70,000 Acres

1 day ago

Clovis, Sanger, Madera, and Bass Lake Will Light the Sky With Fireworks Shows Tonight

1 day ago

Oil Dips Ahead of Expected OPEC+ Output Increase

1 day ago

613 Killed at Gaza Aid Distribution Sites, Near Humanitarian Covoys, Says UN

1 day ago

Fresno County Authorities Investigating Suspicious Death of Transient Man

1 day ago

West Bank Town Becomes ‘Big Prison’ as Israel Fences It In

1 day ago

Israeli Military Kills 20 in Gaza as Trump Awaits Hamas Reply to Truce Proposal

1 day ago

Valley Crime Stoppers’ Most Wanted Person of the Day: Rachelle Maria Blanco

1 day ago

Russia Pounds Kyiv With Largest Drone Attack, Hours After Trump-Putin Call

1 day ago

Boxer Chavez Jr Expected to Be Deported to Mexico to Serve Sentence, Mexican President Says

1 day ago

How Trump’s ‘Big, Beautiful Bill’ Will Make China Great Again

Can you hear it — that loud roar coming from the East? It’s the sound of 1.4 billion Chinese laughing at us. Thomas L. Friedman The New Yo...

7 hours ago

Solar Farm in Riesel, Texas
7 hours ago

How Trump’s ‘Big, Beautiful Bill’ Will Make China Great Again

Caitlin Clark Signs T-Shirt
7 hours ago

What’s Caitlin Clark Worth to the WNBA? A Lot More Than Her $78,066 Salary.

President Donald Trump speaks during a press conference in the Roosevelt Room at the White House in Washington, D.C., U.S., May 12, 2025. (Reuters File)
1 day ago

Trump to Sign Tax-Cut and Spending Bill in July 4 Ceremony

The Madre Fire burning near New Cuyama has scorched 70,801 acres as of Friday, July 4, 2025, afternoon, making it California’s largest wildfire of the year, with only 10% containment and multiple evacuation zones in place. (CalFire)
1 day ago

Madre Fire Spurs Evacuations Across 3 Counties, Grows to More Than 70,000 Acres

1 day ago

Clovis, Sanger, Madera, and Bass Lake Will Light the Sky With Fireworks Shows Tonight

A pumpjack operates at the Vermilion Energy site in Trigueres, France, June 14, 2024. (Reuters File)
1 day ago

Oil Dips Ahead of Expected OPEC+ Output Increase

Palestinians gather to collect what remains of relief supplies from the distribution center of the U.S.-backed Gaza Humanitarian Foundation, in Rafah, in the southern Gaza Strip, June 5, 2025. (Reuters File)
1 day ago

613 Killed at Gaza Aid Distribution Sites, Near Humanitarian Covoys, Says UN

Billy Wayne Sinisgalli, a 54-year-old transient known locally as Wayne, was found dead along a rural Fresno road Wednesday in what authorities are investigating as a suspicious death. (Fresno County SO)
1 day ago

Fresno County Authorities Investigating Suspicious Death of Transient Man

Help continue the work that gets you the news that matters most.

Search

Send this to a friend