Summary: One new study shows that a lipid molecule (a type of fat) made naturally in the human body can modulate pain sensation. It is especially good at lowering pain in people with hyperalgesia, or increased pain sensation. This is a common problem in people living with chronic pain.
Chronic pain is one of the most common health problems. It causes a lot of disability, and yet it is hard to manage. Quite often, the cause of chronic pain is poorly identified. Also, people living with chronic pain show greater pain sensitivity. One new study has found a natural molecule that may help reduce pain sensitivity. Chronic pain specialists have stressed the need for more targeted treatments for heightened pain sensitivity in these conditions.
Higher pain sensitivity shows up in almost all chronic pain. It is seen in people with low back pain, joint pain, fibromyalgia, chronic pain syndrome, Lyme disease, and many other painful conditions.
Science knows that in most chronic pain conditions, this high pain sensitivity is the main cause of lasting pain. Yet most drugs used for chronic pain cannot reduce pain sensitivity. Common painkillers like NSAIDs help reduce inflammation. But they do not reduce pain sensitivity.
Opioids fall short in the same way. They may help suppress pain sensations in the brain. But they do not reduce pain sensitivity.
Even worse, some common painkillers, including opioids, may make people more sensitive to pain. That is why people on opioids or other painkillers find it so hard to stop. If they quit, they feel even worse pain, because their pain sensitivity has gone up.
People with increased pain sensitivity may also have chronic pain more often. For them, any kind of health problem may trigger pain and make things worse. They may have bad pain after a cold, the flu, or another illness. That is also why they may even feel pain from mood changes.
A new study in Nature Communications looked at phosphatidic acid, a lipid found naturally in the human body. Researchers found it can reduce touch sensation. It can also lower the sensitivity of pain receptors. The study found that phosphatidic acid acts as a natural inhibitor (brake) of piezo2 channels and mechanical sensitivity. Piezo2 channels sense touch and pressure. This breakthrough offers hope for institutes like interventional pain management, since they could help cut reliance on standard painkillers by going after the underlying pain mechanisms.
Researchers have long known that certain lipids act as modulators (tuners) of different sensations. They can also tune pain.
It matters to know about these signal molecules our body makes. It means we can safely reduce pain by changing how much of them the body makes. This can be especially good for controlling chronic pain. This approach is also likely to be safer and help with many kinds of pain. In many cases, it may also treat the root cause of chronic pain, which is increased sensitivity to pain.
This is not the first study to show that phosphatidic acid helps regulate pain. This lipid is also sold as a supplement for brain health and is seen as suitable for managing pain. But taken as a supplement, it is not known to have a significant pain-killing effect. There could be several reasons. First, it only lowers pain sensation, so it helps people with hyperalgesia, or increased pain sensation. Second, when taken as a supplement, it just might fail to reach the right body tissues.
To get around these problems, researchers are looking for ways to change how much of it the body makes. This would be a better way to control pain and may bring other health benefits too.
Frequently asked questions
What is hyperalgesia?
Hyperalgesia is increased pain sensation. The nervous system turns up the volume, so the same signal hurts more than it should. It is a common problem in people living with chronic pain. Higher pain sensitivity shows up in almost every chronic pain condition. For many of them, a cold, the flu, another health problem or even a mood change can trigger a bad pain day.
Can opioids make you more sensitive to pain?
Yes. Opioids suppress pain sensations in the brain, but they do not reduce pain sensitivity. Some common painkillers, opioids included, may make people more sensitive to pain. That is why stopping these drugs is so hard. When people quit, they feel even worse pain because their sensitivity has gone up.
Is hyperalgesia the same as fibromyalgia?
No. Hyperalgesia is a feature, not a diagnosis. Fibromyalgia is one condition where it appears. So are low back pain, joint pain, chronic pain syndrome, Lyme disease and many other painful conditions. In most of them, this heightened sensitivity is the main reason the pain persists.
What natural molecule reduces pain perception?
Phosphatidic acid, a lipid the human body makes on its own. A study in Nature Communications found that it acts as a natural brake on PIEZO2 channels. That lowers touch sensation and the sensitivity of pain receptors. So it matters most for people whose pain comes from heightened sensitivity, not new injury.
Does a phosphatidic acid supplement help with pain?
Not in any real way so far. Phosphatidic acid is sold as a brain-health supplement. Taken that way, it is not known to have a significant pain-killing effect. It only lowers pain sensitivity, and a supplement may never reach the tissues that matter. So researchers are looking for ways to change how much the body makes instead.
Source:
Gabrielle, M., Yudin, Y., Wang, Y., Su, X., & Rohacs, T. (2024). Phosphatidic acid is an endogenous negative regulator of PIEZO2 channels and mechanical sensitivity. Nature Communications, 15(1), 7020. https://doi.org/10.1038/s41467-024-51181-4
Dr. Gurpreet Singh Padda, MD, MBA, MHP
