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Persistent Pain  /  Innovative Medical Research

Around 100 million Americans live with persistent pain–more Americans than are affected by diabetes, heart disease, and cancer combined. Persistent pain is a significant public health problem, costing the American economy around $560 to $635 billion annually. This amount is equal to a cost of $2,000 for every US citizen due to cost of health care and lost productivity.

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    • An opiate agonist often used for persistent pain, tramadol was found in one meta-analysis to significantly reduce neuropathic pain when compared to placebo.  
    • Antiepileptic drugs relieve persistent neuropathic pain. One meta-analysis found gabapentin to be associated with moderate benefit (equivalent to 30% pain relief) in close to 1 in 2 patients, and…  
    • Pregalbin, an antiepileptic drug, produced around a 32% pain reduction (a significant reduction) at week 16 versus around 20% for placebo, in patients with neuropathic pain due to spinal cord…  
    • Topical capsaicin was found in a meta-analysis to provide a degree of pain relief to some patients with painful neuropathic conditions.  
    • Topical NSAIDs were found in a meta-analysis to be significantly more effective than placebo in reducing persistent pain from musculoskeletal conditions.  
    • In individuals with persistent low back pain, tanezumab, a humanized anti-nerve growth factor antibody, showed clinical and statistical analgesic efficacy that was superior to placebo and naproxen.  
    • A meta-analysis of duloxetine, an anti-depressant, found a 50% reduction in pain at 12 weeks for diabetic peripheral neuropathy, and a 50% reduction in pain at 12 weeks for fibromyalgia.  
    • A meta-analysis of pscychological interventions for chronic low back pain found small but statistically significant effects for all interventions for as long as 5 years.  
    • A biopsychosocial approach (i.e., one that takes into account physical, emotional, and environmental factors in the assessment and treatment of pain) has been found to improve the pain care of…  
    • Exercise has shown to be effective in reducing persistent pain from osteoarthritis of the knee.  
    • 60% of people with persistent back pain who turned to complementary and alternative medicine perceived a “”great deal”” of benefit.  
    • Acupuncture, in combination with routine care, was associated with marked clinical improvements in patients with persistent low back pain. It has also shown improvement in primary and secondary outcomes…  
    • Opioids have been found to reduce pain intensity and improve physical functioning for patients with persistent noncancer pain. It’s important to note that a decrease in mental health functioning…  
    • Subthalamic nuclei deep brain stimulation (STN-DBS) raises pain thresholds in Parkinson’s disease patients.  
    • An oral cannabinoid was found effective in relieving diabetic peripheral neuropathic pain symptoms and improving disturbed sleep, quality of life, and overall patient status.  
    • Topical clonidine gel significantly reduces foot pain in patients with painful diabetic neuropathy.  
    • Growth hormone treatment in patients with fibromyalgia is effective in reducing pain with sustained action over time.  
    • The use of sodium oxybate (SXB) in fibromylagia patients reduced pain by 30% or more in 54-58% of patients (versus 35.2% for placebo). SXB also reduced fatigue and sleep disturbance.  
    • Pain education programs and pain consultations have been found to improve pain (average pain was 31% versus 20%) and daily interference (20% versus 2.5%) in oncology outpatients. Patient adherence…  
    • The Mayo Clinic Pain Rehabilitation Center helps people with persistent pain return to an active lifestyle and has found that among patients who finish the program, nearly 84% report greater…  
    • 57% of American adults say they would pay an extra $1 per week in taxes in order to support government research into the causes of and treatment for chronic pain.  
    • People with persistent pain who used complementary and alternative medicine (CAM) had lower average health care expenditures than nonusers ($3,797 versus $4,153).  
    • Resolvins, a family of lipid mediators, have shown potential in resolving persistent inflammatory pain.  
    • Nerve growth factor (NGF) has been found to be a major mediator of inflammatory and neuropathic pain and provides a new therapeutic target.  
    • Use of stem cells to create neurons could enable the study of the response of human cells to new drugs in vitro, early in the drug development process.  
    • The combination of information for neuroimaging and circulatory biomarkers could improve both the sensitivity and specificity of pain diagnosis and thereby improve treatment.  
    • Understanding the role of genetics in pain mechanisms is increasing and the potential now exists to conduct genome-wide screens in model organisms to look for pain-associated genes.  
    • Researchers have developed several sub-types of ion channels that allow inflammation and growth factors to trigger persistent pain.  
    • Researchers have discovered that some types of glial cells have a major impact on persistent neuropathic pain and that targeting these cells may result in a new class of disease…  
    • Advances in neuroimaging will continue to offer information on the brain’s functioning and how it correlates to the pain experience.  
    • Targeting A-type K+ channels in primary sensory neurons could provide a novel mechanism-based therapy for the treatment of bone cancer pain–one of the most severe types of chronic pain.  
    • A proteasome inhibitor was found to reduce pain and joint destruction in an animal model of osteoarthritis, suggesting that nontoxic proteasome inhibitors could offer a novel pharmacotherapy option.  
    • Statin use in mouse models show pain-alleviating effects for neuropathic pain.  
    • Brain imaging is showing that pain changes the structure and function of brain regions that perceive pain, making it persistent. These brain networks and receptor targets are being identified…