Most of us don't think about pain until it happens. And when it does, it usually clears up after a few days or weeks. That was my own experience until the summer of 2023. One day I woke up and noticed that my arm hurt. There was no clear explanation and nothing I did. The pain was intense. I could barely do anything: drive, cook, type, even sleep. I had always been healthy and played a lot of sports, so I thought this strange pain was just bad luck. But as the weeks turned into months and I found no cause or cure, I began to realize that I wasn't alone. Chronic pain continues to be prevalent all around me.
As my symptoms dragged on, I started looking into what scientists do and still don't understand about chronic pain. Most of all, I was shocked to learn how little we know about its causes. But we also know that we are in the midst of a revolution that is changing the way we think about and treat chronic pain. (Read the full magazine article.)
Chronic pain is not just a symptom, it's a disease.
We used to think that we might die from pain, but we wouldn't die from it. Chronic pain is now considered to be a disease in itself, occurring when nerves become overactive or “sensitized.” This can happen even if the injury has healed enough to determine the cause of the pain, or even for no reason at all. Scientists were once perplexed by persistent pain, but they now recognize that chronic pain is a disorder of the central nervous system. In some cases, pain signals may continue to be emitted by what researchers now believe to be a complex set of genetic, endocrinological, and immunological processes.
A quarter of the world's population suffers from chronic pain.
Approximately 100 million people in the United States live with chronic pain. There are over 2 billion of them worldwide. Despite these numbers and the financial, physical and emotional burden chronic pain brings, only a fraction of the funding for diseases such as cancer and diabetes is received. And there is no national center to study chronic pain. But researchers are finally beginning to understand the underlying mechanisms of pain and how to treat it.
Some people are more likely to suffer from chronic pain than others.
Women are more likely to develop chronic pain than men. No one is entirely sure why, but researchers cite two possible reasons. One is because women are at higher risk for autoimmune diseases, and the other is because hormonal fluctuations can make pain worse. What we do know is that the development of chronic pain is not necessarily a result of disease severity. Some people with relatively mild tissue damage experience severe pain, while people with severe damage mostly feel okay. And when you experience one type of chronic pain, you're more likely to develop another.
Researchers now believe that chronic pain, such as cancer, may involve a variety of genetic and cellular factors that vary depending on the symptoms and the specific makeup of the person experiencing the pain. I'm thinking.
New research could revolutionize treatment.
One of the hurdles in developing appropriate treatments for chronic pain is that there is no easy way to “see” or measure a person's pain. That is, a way to monitor tumor size and measure how much the cerebral cortex of Alzheimer's patients has shrunk. . All doctors can still do is ask you to rate your pain on a scale of 1 to 10.
Researchers and pharmaceutical companies studying pain, primarily using mice and other animals as surrogates for humans, have invested years and decades into developing new drugs that are ineffective in humans. did. New technology allows researchers to collect and study tissue samples from chronic pain patients to understand what changes occur at the cellular level when pain becomes chronic. The goal is to design drugs that can specifically target these changes. And thanks to new imaging techniques and computing power, researchers can now rapidly collect data on the subtle changes that cause individual patients' conditions, known as pain symptoms.
All of these advances could lead to personalized medicine that has revolutionized cancer treatment, and even drugs that can block pain signals in most people, regardless of the cause.
On the other hand, there are also specialized pain clinics.
Patients with chronic pain are often stigmatized and even ignored, in part because many doctors lack the necessary training to help them. However, there is increasing recognition of the complexity of pain and the need for individualized management. More and more patients are turning to pain clinics that offer that possibility. There, you can benefit from a multidisciplinary approach, including physical therapy, psychological counseling, specialist pharmacists, and neurologists. This more time-consuming and careful approach helps identify all possible causes and identifies medications and other treatments that are most likely to help patients live better with their pain. . Although we do not yet have the tools to reliably measure pain neuronal dysfunction or changes in the brain's pain circuitry, we are finally getting closer to large-scale, personalized pain treatments that will ultimately alleviate patient suffering. Maybe.
