Chronic Pain and the Development of PainRelieving Medications
It takes a villageonly after Research appreciates the villagers.
Published on July 29, 2011 by Dr. Mark Borigini in Overcoming Pain
Chronic pain remains an unsolved public health problem. Millions ofAmericans live with chronic pain, impacting many aspects of the lives of thesufferers-and those who interact with the sufferers, whether they be family,friends, or employers. In fact, chronic pain has a greater impact on the UnitedStates economy in terms of health insurance, lost wages and reduced productivity than virtually any other chronic health condition, includingdiabetes, hypertension, and heart disease.
There are several methodological issues that hinder thedevelopment of novel pain-relieving medications. For example, over the lastcouple of hundred years, most pain research has focused on more transient painmodels that do not result in tissue damage, and thus do not reflect what isoccurring in a chronic pain patient. On the other hand, studies focusing solelyon patients suffering from chronic pain may miss time points when anintervention aimed at preventing chronic pain is most effective. Are theremissed opportunities whereby central sensitization can be interrupted,effectively halting the metamorphosis of acute injury to chronic pain?
Scientists have sequenced the human genome, cloned all sorts oforganisms, and developed a variety of biological agents to treat heretoforedifficult to treat conditions. However, there have been few new drugs to treat pain over the last couple ofdecades.
Therefore, many researchers are beginning to call for a shift inthe strategies utilized in the development of pain medications. It is importantto understand the changes in the nervous system that result in the pain experience,and this encompasses the appreciation that acute and chronic pain are differententities. Researchers must measure many signs and symptoms when studying pain,not just whether a patient states their pain is a “2” or a”10″.
The principles of pharmacogenomics may assist researchers intheir quest for targeted pain relief. It might be possible to uncover a causalrelationship between genetic make-up and the response to medications.
It follows that the appropriate measures of patient response arecrucial in establishing a pattern of response, or lack therof. A focus on theindividual can thus lead to the identification of cohorts of pain suffererswhose genetic pain mechanism “fits” a particular pharmacologicintervention.
Answers to the conundrum of chronic pain, its relation to acutepain, and the genetic and psychological composition of the individual, aregoing to be found in the individual. This will go a long way to helping thegeneral population of chronic pain patients.
It takes a village only after Research appreciates thevillagers.


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