University of California, Los Angeles, Calif.

Dr. Lonnie Zeltzer and Dr. F. Michael Ferrante on pain research at UCLA

— -- Pediatric Pain Program and Pain Management Center at UCLA

UCLA has programs to treat both adults and children. Research at the Pediatric Pain Program at Mattel Children's Hospital UCLA focuses on experimental treatments for pain in children; pain narratives; pain interventions, including complementary therapies; pain in childhood cancer survivors; and pain in the context of palliative care.

Funded by the National Institutes of Health, the program's experimental pain studies examine the roles of parents, gender, sex and puberty in children's responses to pain. Additional research, funded by the National Institute of Mental Health, is exploring pain narratives--the oral histories of children suffering from chronic pain--and involves faculty and fellows from the fields of pediatrics, psychology, history, sociology and anthropology.

In addition, the program has been studying a number of complementary pain-management interventions, including Iyengar yoga, meditation, massage therapy, acupuncture and hypnotherapy.

For the past 13 years, the program has been involved in a collaborative study of 18,000 adult survivors of childhood cancer and about 13,000 of their siblings, with support from the NIH. The program has also focused on long-term pain, with funding support from the Lance Armstrong Foundation.

The program's pediatric palliative care studies, funded initially by the Glaser Pediatric Network and more recently by the American Cancer Society and the UniHealth Foundation, have looked at communication about pain and other symptoms between parents and children with life-threatening advanced disease.

For adults suffering from pain, the UCLA Pain Management Center focuses on the treatment of spinal and associated muscular conditions. Although muscle is the second largest organ in the human body after the skin, little is known about muscular pain -- or the capacity of muscles to generate headaches and migraine.

Research at the Pain Management Center is exploring possible connections between muscle-related neck pain and headaches and migraine. Studies involve the potential use of botulinum toxins to treat muscular neck pain with postural abnormalities and headache. According to center director Dr. F. Michael Ferrante, a clinical professor of anesthesiology, botulin, in very small doses, can act as a muscle relaxant and could be useful for such painful spasmodic conditions. Efforts are also underway to identify the characteristics that may make individuals successful candidates for botulinum toxin therapy for reducing muscle pain. The studies are funded by Allergan Inc.

In addition, the center is investigating mechanical — or "bony" — back pain, particularly in patients with non-inflammatory problems of the sacroiliac joint, which is located between the sacrum, at the base of the spine, and ilium of the pelvis. Radiofrequency lesioning (cauterization of pain nerve fibers) has resulted in dramatic improvement in the treatment of sacroiliac disease, and research at the center involves discerning which radiofrequency techniques have the most beneficial outcome for patients. Additional studies examine quality-of-life issues for patients with sacroiliac syndrome, in contradistinction to other spinal conditions.