From Mechanism to Cure: Renewing the Goal to Eliminate the Disease of Pain

Pain Med. 2018 Aug 1;19(8):1525-1549. doi: 10.1093/pm/pnx108.

Abstract

Objective: Persistent pain causes untold misery worldwide and is a leading cause of disability. Despite its astonishing prevalence, pain is undertreated, at least in part because existing therapeutics are ineffective or cause intolerable side effects. In this review, we cover new findings about the neurobiology of pain and argue that all but the most transient forms of pain needed to avoid tissue damage should be approached as a disease where a cure can be the goal of all treatment plans, even if attaining this goal is not yet always possible.

Design: We reviewed the literature to highlight recent advances in the area of the neurobiology of pain.

Results: We discuss barriers that are currently hindering the achievement of this goal, as well as the development of new therapeutic strategies. We also discuss innovations in the field that are creating new opportunities to treat and even reverse persistent pain, some of which are in late-phase clinical trials.

Conclusion: We conclude that the confluence of new basic science discoveries and development of new technologies are creating a path toward pain therapeutics that should offer significant hope of a cure for patients and practitioners alike. Classification of Evidence. Our review points to new areas of inquiry for the pain field to advance the goal of developing new therapeutics to treat chronic pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Central Nervous System Sensitization / physiology*
  • Chronic Pain / physiopathology*
  • Humans