Chronic pain can affect a person’s life in a myriad of ways. Asal Shirazi BEM, Founder of the Autoimmune Support & Awareness Foundation (ASA Foundation), talks us through some of the conditions associated with chronic pain and the advancements in pain management
Chronic pain is defined as persistent discomfort that lasts for an extended duration, typically beyond three to six months. This condition can arise from various underlying issues, including arthritis, fibromyalgia, or past injuries, and may not always have a clearly identifiable cause. Unlike acute pain, which acts as a warning signal for injury or illness and subsides as the underlying issue resolves, chronic pain frequently continues even after the initial cause has been addressed. This condition can profoundly affect an individual’s quality of life, encompassing physical, emotional, and social dimensions. Management strategies may involve a combination of medication, physical therapy, lifestyle modifications, and other interventions aimed at alleviating symptoms and enhancing overall functionality.
The prevalence of chronic pain
According to the British Pain Society, it is estimated that 43% of adults (just under 28 million people) currently live with a degree of chronic pain in the UK. Chronic pain may affect up to 30% of young adults of working age (18-39 year-olds). The prevalence in older age groups is even higher, with up to 62% of those aged 75 years and over reporting chronic pain symptoms. The provenance of chronic pain is similar in all ethnic groups (34%) but is higher in people in the Black ethnic group (44%).
The impact of chronic pain
Severe chronic pain is associated with an increased risk of mortality, independent of socio-demographic factors. Low back and neck pain have consistently been the leading causes of disability internationally, with other chronic pain conditions featuring prominently in the top ten causes of disability. Forty-one per cent of people who attended pain clinics report that their pain has prevented them from working, and 13% have had to reduce their working hours.
The percentage of patients cited in the above are only those registered with the British Pain Society or that we know of; there are plenty more pain sufferers who are not registered. Therefore, it can be assumed that the figures are higher due to the current prevalence of autoimmune conditions and the documented yearly increase of 10% or more, depending on the condition.
Chronic pain in the UK can be associated with a variety of conditions, including arthritis (conditions like osteoarthritis and rheumatoid arthritis can lead to persistent pain in joints); fibromyalgia (this syndrome results in widespread musculoskeletal pain, fatigue, and tenderness); back pain (chronic lower back pain is common and can stem from various causes, including herniated discs or degenerative disc disease); neuropathic pain (conditions like diabetes can lead to nerve pain, often described as shooting or burning); headaches and migraines (chronic headaches and migraines can significantly impact daily life and wellbeing); cancer (pain can arise from the disease itself or as a side effect of treatments like chemotherapy or radiation); Irritable Bowel Syndrome (IBS) (this digestive disorder can cause abdominal pain that lasts for an extended period); Multiple Sclerosis (MS) (this neurological condition can lead to various types of pain due to nerve damage); post-surgical pain (some individuals may experience persistent pain following surgery, termed chronic post-surgical pain); psychological factors (conditions such as depression and anxiety can contribute to the experience of chronic pain).
Each of these conditions can manifest differently and may require various management strategies. If you or someone you know is experiencing chronic pain, it’s essential to consult with a healthcare professional.
Treating chronic pain
Opioids are commonly used for treating pain and include medicines such as morphine, fentanyl and tramadol. However, prolonged use, misuse and use without medical supervision can lead to opioid dependence and other health problems. According to the WHO, in 2019, about 600,000 deaths were attributable to drug use globally, and close to 80% of these deaths were related to opioids. Research is continuing to find non-opioid painkillers, and there is much research and initiatives in regenerative medicine towards pain management. The advancements in pain management highlight promising non-opioid treatments and innovative technologies that could reshape care.
Non-opioid medications: Suzetrigine, developed by Vertex Pharmaceuticals, is an experimental analgesic targeting acute pain by blocking pain signals in the peripheral nervous system. It avoids the addictive effects of opioids and has shown effectiveness in post-operative pain relief. The FDA has granted the drug priority review, with potential approval in early 2025.
Neuromodulation Innovations: The Injectrode, a flexible wire that delivers electrical impulses to specific nerves, is gaining attention. It is minimally invasive, cost-efficient, and could replace traditional spinal cord stimulators for chronic conditions like back pain and neuropathy. It also has applications beyond pain, such as managing hypertension.
Novel receptor targets: Researchers are exploring the sigma-2 receptor/TMEM97 ligand, FEM-1689, as a neuropathic pain treatment. This compound inhibits stress responses linked to chronic pain and represents a new therapeutic pathway.
These developments reflect the push for safer, effective alternatives to opioids, driven by the ongoing opioid crisis and increased federal support through policies like the NOPAIN Act, which expands Medicare coverage for non-opioid treatments.
Regenerative medicine is transforming chronic pain management by utilizing the body’s natural healing mechanisms through therapies like stem cell treatments and platelet-rich plasma (PRP) injections. These approaches offer promising alternatives to traditional methods such as medications or surgery.
Stem cell therapy
Stem cells, particularly mesenchymal stem cells (MSCs), are harvested from bone marrow or adipose tissue. These cells can regenerate damaged tissues, reduce inflammation, and alleviate pain, making them suitable for conditions like osteoarthritis, neuropathic pain, and degenerative disc disease. The therapy involves targeted injections into affected areas to promote cellular repair and regeneration. This method is gathering momentum but needs better regulation globally.
PRP therapy
This involves injecting concentrated platelets derived from a patient’s blood into damaged tissues. The growth factors in PRP stimulate healing, reduce inflammation, and improve local circulation. PRP is particularly effective for tendon injuries, osteoarthritis, and chronic lower back pain.
These therapies aim to address the root causes of pain by healing tissues rather than merely suppressing symptoms. They are increasingly being integrated into personalized pain management strategies, often alongside physical therapy and lifestyle modifications. Unlike conventional methods like corticosteroid injections, which provide temporary relief, regenerative techniques focus on long-term recovery and tissue health.
While these methods show significant promise, they are not yet widely accessible due to cost, insurance coverage issues, and the need for standardization of treatment protocols. Research is ongoing to optimize their application and ensure broader availability.
These advances represent a pattern shift in how chronic pain is managed, offering hope for lasting relief and improved quality of life.
