Superstars of STEM: Finding a better way to understand pain

“Pain” is the most searched health-related term on Google and is considered the “fifth vital sign” for monitoring medical care, yet the available methods to establish and quantify it are extremely inaccurate and subjective.

Current methods for rating pain are primarily based on patient self-scoring on a scale of one to 10, or by choosing from a series of faces depicting different levels of discomfort. These can be problematic, for a few reasons.

The first is that pain is subjective and felt differently by different people. The experience can be shaped by previous episodes, or by the body’s sensitivity.

The second is that children, dementia patients, and those unable to communicate verbally are often not able to meaningfully rate, assess or communicate their discomfort, rendering it impossible to gain a proper understanding of their situation. This can mean difficulty in diagnosis and prescribing pain medication.{%recommended 4358%}

Finally, in cases where addiction is an issue, patients may inflate or manufacture their pain in order to receive medication. With over 70% of drug-related deaths in Australia implicating prescription opioids in 2017, over-prescribing is a real problem.

Sanam Mustafa from the Centre for Nanoscale BioPhotonics in Adelaide, Australia, is looking to solve this issue by designing a test that eliminates the self-assessment. She is working with a team to design a simple blood test that will confirm the presence of pain, and provide an indication of its severity. Currently in its early stages, Mustafa says results have been promising.

“We’ve found colour changes in samples of tissue from animals that have felt pain,” Mustafa says.

“By utilising the auto-florescence, or natural colour of tissue, we have been able to record significant changes following the experience of pain.”

Her team used hyperspectral imaging to identify changes in endogenous fluorescent molecules such as flavins, bound and free NADH, and retinoids that are involved in cell metabolism. This allowed them to identify that certain metabolic differences between samples were bio-indicators of pain.

She explains that this is a completely different way of looking at the phenomenon – identifying the global changes causing or as a result of pain, rather than focusing on the individual receptors or signalling pathways involved in communication.

Mustafa says the hope is that similar colour changes can be identified in blood or saliva, because these samples are easy and quick to collect for accurate quantification and can be rolled out to hospitals and doctors’ clinics.

“It’s a few years away, but eventually we believe we will have a blood test, or even a saliva test, that will help pinpoint the severity of a patient’s pain,” she explains.

“This will mean great benefits for patients and doctors, as we will have more accurate diagnosis and the ability to individualise pain treatments, significantly reducing the risk of addiction and under- or over-prescription of pain medication.”

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Sanam Mustafa is among 30 Superstars of STEM featured in this weekly series prepared by Science & Technology Australia (STA). To learn more about the program, visit the STA website.