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May 17, 2023

Chronic pain is more common than diabetes and depression, new study finds

Researchers are trying to identify the nerve cells responsible for the physical sensation of pain

Adult Health Chronic Pain
Chronic pain Source/Image licensed from Ingram Image

Low back pain, headaches, cancer pain and arthritis pain are the most common types of chronic pain.

People are developing chronic pain at higher rates than they are being diagnosed with diabetes, high blood pressure, depression and asthma, a new study finds.

The study, which defined chronic pain as having pain on most or all days, found that 6.3% of participants who did not have any pain in 2019 reported experiencing chronic pain in 2020. Another 14.9% who reported non-chronic pain in 2019 also went on to develop chronic pain. Researchers say this points to the importance of early pain management.

"While 10% of people who recover from chronic pain give us hope, we have an urgent scientific imperative to expand our tools and fight pain so we can restore many more to a pain-free life," said Dr. Helene M. Langevin, director of the National Center for Complementary and Integrative Health. 

"The onset of any chronic condition is a pivotal moment and early intervention can make a significant difference in the toll that the condition takes on the individual."

The researchers found there were about 52 new chronic pain cases per 1,000 people each year. By contrast, there were about 45 hypertension diagnoses, 16 depression cases and 7 diabetes diagnoses per 1,000 people. 

Entering the study, nearly 21% of participants reported chronic pain. The only condition with a higher pre-existing rate was hypertension, at 48%. The study also found that people ages 50 and older have a higher risk of chronic pain than younger adults. 

Pain, whether from an injury or illness, starts in nerve receptor cells beneath the skin. These cells send messages to the spinal cord which then sends them to the brain. Treatment for pain focuses on trying to block these messages from getting to the brain.

Pain can be acute, meaning recent; subacute, which lasts for a few weeks or months; or chronic, meaning more than 3 months, according to Johns Hopkins Medicine. Chronic pain can lead to costly medical bills, lost income and poor quality of life. It is a major health problem in the U.S. that also has economic consequences — scientists estimate that $300 billion is lost every year to work absences due to chronic pain.

Low back pain, headaches, cancer pain and arthritis pain are the most common types of chronic pain. Some people, however, experience chronic pain that has no discernible cause. Managing chronic pain is often challenging because pain is subjective and its cause isn't always easily diagnosed and treated.

Many people living with chronic pain, like those with complex regional pain syndrome, often feel a stigma attached to their conditions because family and friends don't understand how truly debilitating their pain can be.

Chronic pain is often first treated with ibuprofin, acetaminophen or prescription pain medicines, including opioids, though doctors try to limit opioid use due to the risk of addiction. Some people also find relief from prescription antidepressants, which have been shown to increase levels of serotonin, a neurotransmitter that helps control pain.

Non-pharmacological treatments include hot and cold therapy, physical and occupational therapy, massage, electrical stimulation and epidural steroid injections. Surgery may be needed for cases of extreme pain. Psychotherapy to treat depression and anxiety can also help, as can lifestyle changes like reducing stress, getting a good night's sleep, healthy eating and regular exercise.

Music therapy has also shown some promise for treating chronic pain. Studies have shown that music decreases chronic pain through the release of endorphins and changes in the levels of catecholamine, a hormone released in response to emotional or physical pain. Music can also distract from pain when it triggers memories.

New research is exploring better ways to reduce chronic pain by focusing on the nerve cells. Gregory Scherrer, who studies how the body and brain process pain at the University of North Carolina School of Medicine, told NBC News that scientists are trying to identify the nerve cells responsible for the physical sensation of pain so they can develop pain medicine that is not addictive.

"The goal would be to be able to shut off those cells or decrease their activity," he said.

Researchers have also been exploring how electrodes or magnets can be used to stimulate nerve cells. In one technique, called peripheral nerve stimulation, surgeons implant electrodes along the nerves outside of the brain and spinal cord. These electrodes then send electrical pulses to the nerves, tricking the brain into either reducing or completely shuttering pain signals. Another procedure, called transcranial magnetic stimulation, works in a similar way by holding an electromagnetic coil against the scalp. This is a less invasive procedure that doesn't require surgery.

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