Dr. Gary Kaplan, along with co-author Juliana Heimur, BA, recently contributed to The Pain Practitioner, the quarterly magazine published by the American Academy of Pain Management (AAPM). The article, titled “Microglia and Central Sensitization Syndrome: A New Paradigm for Understanding and Treating Chronic Pain and Depression,” discusses the role of microglia, a type of glial cell present in the central nervous system, as the mediator in the inflammatory process found to be present in central sensitization.
Central Sensitization Syndrom (CSS) is an inflammatory condition that damages the structure and undermines the functioning of the nervous system. It is both “neurodysregulatory” and “neurodegenerative.” Neurodysregulation refers to the extent to which CSS interferes with the healthy functioning of the body’s nervous system, undermining neural activity in the brain, spinal cord and other neural pathways throughout the body. Furthermore, when a person’s nervous system is operating sub-optimally, their hormonal and immune systems are likely to falter, which in turn, can lead to even more complicated health problems. Neurodegeneration refers to the actual injury and destruction of neural tissue in the brain and body. Both conditions (neurodysregulation and neurodegeneration) can cause or exacerbate physical pain, emotional suffering, and erode mental clarity. The mediating factor in this process is the production and release of inflammatory substances in the brain.
At the cellular level, the fundamental mediator of CSS is the microglia. What we are learning about the pathophysiology of CSS enables us to formulate a new paradigm for understanding how a variety of seemingly unrelated illnesses and traumas can result in CSS. In this article Dr. Kaplan discusses the research on the neurobiology of microglia and their role in the occurrence of central sensitization with emphasis on the clinical implications and application of this research.
Please click here or on the image below to download and read Dr. Kaplan’s featured article.
Dr. Kaplan has been appointed by U.S. Secretary of Health and Human Services (HHS), Kathleen Sebelius, to the Chronic Fatigue Syndrome Advisory Committee (CFSAC). The Committee provides advice and recommendations to the Secretary of HHS through the Assistant Secretary for Health on issues related to myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS), such as access and quality of care for persons with CFS, the science and definition of CFS, and broader public health, clinical, research and educational issues related to CFS.
Dr. Kaplan is one of four individuals on the 11-person Committee who brings special expertise in healthcare delivery, insurance, and the problems experienced by individuals with CFS.
Chronic Fatigue Syndrome (CFS) (sometimes referred to as “Myalgic Encephalomyelitis” or “ME”) is a debilitating disease characterized by fatigue that interferes with your ability to actively engage in many of life’s activities. It can undermine your capacity to be productive at work, to maintain positive relationships with your family and friends, and to enjoy other recreational activities.
In addition to a chronic feeling of fatigue, its major symptoms include:
Cognitive difficulties – difficulty with memory and concentration
A sore throat
Increased levels of fatigue and discomfort following exertion
Other symptoms that sometimes are associated with Chronic Fatigue Syndrome include:
Gastrointestinal problems
Psychological issues
Sensitivity to lights and sounds
Visual difficulties
Chills
Dizziness
More About Chronic Fatigue Syndrome
To learn more about how The Kaplan Center physicians diagnose and care for patients with Chronic Fatigue Syndrome, please click here. Dr. Kaplan has written and lectured extensively on the topic of Central Sensitization Syndrome (CSS), a complex neuro-physiological reaction that can cause chronic fatigue and chronic pain. To watch Dr. Kaplan’s CSS video series, please click here.
Scientists at the University of Southern Denmark say, “Maybe.” New research indicates that 20 to 40 percent of all chronic, lower back pain is caused by bacterial infection and that treating this infection with an extended course of antibiotics can help many patients avoid back surgery.
As a physician who cares for patients with chronic low back pain, I am thrilled about this news! Although surgery is necessary and effective for some patients; far too often, we see patients who still suffer from chronic, low back pain even after undergoing surgery. Learning that a bacterial infection may be the culprit in some of these cases gives us a very promising treatment option to explore.
The results of the Denmark research, which was conducted over a period of 10 years, were reported in two papers published in the peer-reviewed European Spine Journal. The first paper explained how a bacterial infection within a slipped disc causes painful inflammation and small fractures in nearby vertebrae. According to the scientists, when a person suffers a slipped disk, the body grows small blood vessels into the disk to promote healing. But when the microbe commonly associated with acne, “propionibacterium acnes,” is present in that person’s bloodstream, it can get ferried into the disc, causing inflammation in that disc and the surrounding area.
In their second paper, the researchers showed that a 100-day course of the antibiotic “amoxicillin clavulanate” could alleviate chronic, low-back back pain. This double-blind, randomized control trial included 162 individuals, some of whom took the antibiotic, and some of whom took a placebo. Using the Roland-Morris Disability Questionnaire (PDF) to rate their back-pain levels, the group who took the antibiotic reported that their pain dropped from “15” to “11.5” after 100 days, and further improved to “7” after one year. These results stand in sharp contrast to the placebo group, who, after 100 days reported that on average their pain levels fell from “15” to “14.” After 1 year, the placebo group remained at “14.”
It’s important to note that this study did not include people suffering from acute or sub-acute back pain – only those suffering from long-term, lower back pain that lasted six months or longer.
Furthermore, all of the participants underwent MRI scans that proved that they had damaged vertebra. Although additional research is needed to investigate whether individuals suffering from any other kinds of back pain might benefit from taking a course of antibiotics, we now have another tool to help at least some patients obtain pain relief without undergoing surgery.
Of course, we must be mindful that the long-term use of antibiotics can cause other health issues, such as digestive problems and nutritional deficiencies. Therefore, if you consider this treatment, be sure to ask your physician about the possibility of taking probiotics and nutritional supplements to mitigate possible side effects.
Dr. Gary Kaplan Explains Central Sensitization Syndrome in The Pain Practitioner
/in News/by Kaplan CenterDr. Gary Kaplan, along with co-author Juliana Heimur, BA, recently contributed to The Pain Practitioner, the quarterly magazine published by the American Academy of Pain Management (AAPM). The article, titled “Microglia and Central Sensitization Syndrome: A New Paradigm for Understanding and Treating Chronic Pain and Depression,” discusses the role of microglia, a type of glial cell present in the central nervous system, as the mediator in the inflammatory process found to be present in central sensitization.
Central Sensitization Syndrom (CSS) is an inflammatory condition that damages the structure and undermines the functioning of the nervous system. It is both “neurodysregulatory” and “neurodegenerative.” Neurodysregulation refers to the extent to which CSS interferes with the healthy functioning of the body’s nervous system, undermining neural activity in the brain, spinal cord and other neural pathways throughout the body. Furthermore, when a person’s nervous system is operating sub-optimally, their hormonal and immune systems are likely to falter, which in turn, can lead to even more complicated health problems. Neurodegeneration refers to the actual injury and destruction of neural tissue in the brain and body. Both conditions (neurodysregulation and neurodegeneration) can cause or exacerbate physical pain, emotional suffering, and erode mental clarity. The mediating factor in this process is the production and release of inflammatory substances in the brain.
At the cellular level, the fundamental mediator of CSS is the microglia. What we are learning about the pathophysiology of CSS enables us to formulate a new paradigm for understanding how a variety of seemingly unrelated illnesses and traumas can result in CSS. In this article Dr. Kaplan discusses the research on the neurobiology of microglia and their role in the occurrence of central sensitization with emphasis on the clinical implications and application of this research.
Please click here or on the image below to download and read Dr. Kaplan’s featured article.
Dr. Kaplan Appointed to the National Chronic Fatigue Syndrome Advisory Committee
/in News/by Kaplan CenterDr. Kaplan has been appointed by U.S. Secretary of Health and Human Services (HHS), Kathleen Sebelius, to the Chronic Fatigue Syndrome Advisory Committee (CFSAC). The Committee provides advice and recommendations to the Secretary of HHS through the Assistant Secretary for Health on issues related to myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS), such as access and quality of care for persons with CFS, the science and definition of CFS, and broader public health, clinical, research and educational issues related to CFS.
Dr. Kaplan is one of four individuals on the 11-person Committee who brings special expertise in healthcare delivery, insurance, and the problems experienced by individuals with CFS.
Chronic Fatigue Syndrome (CFS) (sometimes referred to as “Myalgic Encephalomyelitis” or “ME”) is a debilitating disease characterized by fatigue that interferes with your ability to actively engage in many of life’s activities. It can undermine your capacity to be productive at work, to maintain positive relationships with your family and friends, and to enjoy other recreational activities.
In addition to a chronic feeling of fatigue, its major symptoms include:
Other symptoms that sometimes are associated with Chronic Fatigue Syndrome include:
More About Chronic Fatigue Syndrome
To learn more about how The Kaplan Center physicians diagnose and care for patients with Chronic Fatigue Syndrome, please click here. Dr. Kaplan has written and lectured extensively on the topic of Central Sensitization Syndrome (CSS), a complex neuro-physiological reaction that can cause chronic fatigue and chronic pain. To watch Dr. Kaplan’s CSS video series, please click here.
Can Antibiotics Cure Your Chronic Back Pain?
/in Treatments/by Gary Kaplan, DOScientists at the University of Southern Denmark say, “Maybe.” New research indicates that 20 to 40 percent of all chronic, lower back pain is caused by bacterial infection and that treating this infection with an extended course of antibiotics can help many patients avoid back surgery.
As a physician who cares for patients with chronic low back pain, I am thrilled about this news! Although surgery is necessary and effective for some patients; far too often, we see patients who still suffer from chronic, low back pain even after undergoing surgery. Learning that a bacterial infection may be the culprit in some of these cases gives us a very promising treatment option to explore.
The results of the Denmark research, which was conducted over a period of 10 years, were reported in two papers published in the peer-reviewed European Spine Journal. The first paper explained how a bacterial infection within a slipped disc causes painful inflammation and small fractures in nearby vertebrae. According to the scientists, when a person suffers a slipped disk, the body grows small blood vessels into the disk to promote healing. But when the microbe commonly associated with acne, “propionibacterium acnes,” is present in that person’s bloodstream, it can get ferried into the disc, causing inflammation in that disc and the surrounding area.
In their second paper, the researchers showed that a 100-day course of the antibiotic “amoxicillin clavulanate” could alleviate chronic, low-back back pain. This double-blind, randomized control trial included 162 individuals, some of whom took the antibiotic, and some of whom took a placebo. Using the Roland-Morris Disability Questionnaire (PDF) to rate their back-pain levels, the group who took the antibiotic reported that their pain dropped from “15” to “11.5” after 100 days, and further improved to “7” after one year. These results stand in sharp contrast to the placebo group, who, after 100 days reported that on average their pain levels fell from “15” to “14.” After 1 year, the placebo group remained at “14.”
It’s important to note that this study did not include people suffering from acute or sub-acute back pain – only those suffering from long-term, lower back pain that lasted six months or longer.
Furthermore, all of the participants underwent MRI scans that proved that they had damaged vertebra. Although additional research is needed to investigate whether individuals suffering from any other kinds of back pain might benefit from taking a course of antibiotics, we now have another tool to help at least some patients obtain pain relief without undergoing surgery.
Of course, we must be mindful that the long-term use of antibiotics can cause other health issues, such as digestive problems and nutritional deficiencies. Therefore, if you consider this treatment, be sure to ask your physician about the possibility of taking probiotics and nutritional supplements to mitigate possible side effects.