Pain is a warning signal that helps protect us from harm. If you felt really bad pain after accidentally burning your hand on a hot stove top, you would be careful not to touch a hot stove top in the future. Pain that heals within an expected time is called "acute pain." For some people, though, pain from an injury - or other form of tissue damage - lasts longer than the expected healing time. Sometimes, it might even be hard for someone to tell why her/his pain started in the first place. Pain that lasts over 3-6 months, or beyond the expected healing time, is called "chronic pain." Chronic pain does not have the same helpful function as acute pain. Instead, chronic pain is often associated with sleep problems, depression, anxiety, disability, and overall reduced quality of life. Research at the BMRL is focused on understanding why chronic pain happens and what can be done to treat it.
HOW DOES THE BMRL STUDY PAIN?
We use many different tools to study how and why chronic pain happens. Not all of our studies use all of these tools, but here are some of the measures we most commonly use:
Quantitative Sensory Testing
Most of our studies on chronic pain use a suite of tools for quantitative sensory testing (QST). QST is a way of measuring how people experience heat/cold, pressure, electric, and/or chemical sensations that might cause minimal to a lot of temporary discomfort. The information that we get from QST helps us understand the role of our nervous system in chronic pain. It also helps us understand how different factors - like pain coping styles, demographic characteristics, and treatments - influence pain processing.
The BMRL's QST program is directed by Dr. Claudia Campbell, and the BMRL has testing rooms at the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center. Each testing room has a wide array of QST tools, such as von Frey monofilaments, weighted probes (i.e., “pinprick”), pressure algometers, thermal stimulators, cold pressors, topical capsaicin, ischemic cuff, and electrical reflex stimulator.
If you are participating in a study that uses QST, you will likely experience only a selection of these tools, and you will be encouraged to let the technician you are working with know if any of the tests cause you too much discomfort.
Did you know that your brain plays a big role in your experience of pain? Although we know that the brain is important for pain, we are still finding out exactly how and why it contributes to chronic pain and its treatment. At the BMRL, we are interested in understanding how brain structure (what your brain looks like) and function (how your brain sends signals) influence pain.
The BMRL's Brain Imaging program is part of a collaboration with University of Maryland, Baltimore researcher, David A. Seminowicz, PhD. For BMRL studies involving brain imaging, participants will completing scanning at the University of Maryland, Baltimore Center for Advanced Imaging Research.
Our brain imaging studies usually take 1-2 hours of active brain scanning time. We take pictures of what your brain looks like and pictures of the activity happening in your brain. You might be asked to complete activities, or just remain as still as possible, while we take these pictures. You will hear noises - like the ones in the video to the left - as we take these pictures.
When you come into the research lab, we might ask about what your thoughts, emotions, and actions are like in your daily life. Sometimes, though, we want to get a snapshot of these factors while you are in your natural environment. Ambulatory monitoring allows us to ask you questions about your behaviors, thoughts, emotions, and other physiological factors at specific moments during the day when you are outside of the lab. Many ambulatory monitoring tools are designed to capture - in real-time - how these factors vary throughout the day. The BMRL uses a variety of ambulatory monitoring tools across our research studies. Most commonly, our studies use smartphone-based technology to prompt study volunteers with questions that are relevant to the goals of the research.