"Pain Management in Connective Tissue Disorders" - Pradeep Chopra, MD

Dr. Pradeep Chopra's talk at the 2018 CSF Disorders Symposium focuses on pain management strategies for patients with Ehlers-Danlos Syndrome (EDS), particularly addressing the challenges of chronic and neurologic pain. He explains the concept of micro and macro trauma in EDS patients and elucidates why these individuals often experience significant chronic pain due to joint laxity and poor healing. Chopra highlights the prevalence of neuropathic pain over nociceptive pain in EDS, proposing that central sensitization is a key driver, where glial cells in the central nervous system become activated, leading to neuroinflammation. He discusses various comorbid conditions associated with EDS, such as cranial cervical instability, TMJ dysfunction, autonomic dysfunction like POTS, and mast cell activation syndrome. The talk emphasizes the multifactorial nature of pain in EDS and suggests that management must be comprehensive, targeting both the biological mechanisms and alleviating symptoms with interventions such as stabilization exercises and consideration for mitochondrial dysfunction and MTHFR genetic variants.