The Pain Puzzle
To truly understand pain, we must unravel a tangled web of biological, social and psychological factors.
Roger B. Fillingim |
Chronic pain is the most prevalent and expensive public health problem in the developed world, but as a society we consistently fail to recognize the scale of the public health issue. Society has a unique and complex relationship with pain, not seen with other illnesses. No one ever said “no cancer, no gain”, but we persist in a belief that pain makes us stronger. We haven’t declared a “war on pain” or launched a “moonshot to cure pain”. Politicians do a lot of saber-rattling about how they are going to tackle the opioid crisis, but I have yet to hear them suggest that we fund more pain research to develop alternative therapies.
When I think about patients I treated 25 years ago, the reality is that there is little I could offer them now, that I couldn’t back then. Pain research hasn’t received the attention and funding to make the breakthroughs that have been made in other fields, and we still have a lot to learn before we can make substantial advances in managing pain.
My lab asks the question: “Why are people so different in their responses to pain?” We know from centuries of clinical experience that the same painful event causes dramatically different responses in different people. We already know that there are many different characteristics that determine an individual’s pain sensitivity. There are well-documented gender, ethnic and age-related differences in how we respond to pain. A handful of genes have been consistently associated with pain sensitivity, and a large number of psychological factors have been shown to have an impact.
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