The Fight for Chronic Pain Treament
According to CDC, at least 51.6 million American adults suffer from chronic pain. For a disease impacting that many people, it’s hard to believe the struggle it is for many to be properly diagnosed and treated.
For a long time, all pain was thought to be linked to an underlying cause. After all, it’s a signal of danger or a sign of illness and disease. Increasingly we find that pain can linger even after the cause has resolved, and that there are genetic and other pain conditions for which there is no obvious cause. But chronic pain is real and the toll it takes on the lives of its victims, their families, co-workers and communities is also very real.
Different Kinds of Pain
Today, there are three, clinically recognized and distinct types of pain:
Acute Pain: Acute pain is clinically defined as pain which lasts for 90 days or less. It’s typically associated with a sudden cause, like surgery, a broken bone or a traumatic impact injury. Because it’s short in duration and usually severe, acute pain is often treated with powerful drugs.
Episodic Pain: This is pain that comes and goes. It’s can be associated with a chronic condition like sickle cell disease or naturally-occurring events like menstrual cycles. But just as often, there is no specific cause or trigger for episodic pain like migraines or sciatica. These conditions are also frequently treated with the powerful medications since “pain spells” or “flare ups” are usually limited in duration, so fear of dangerous side effects is relatively moderate.
Chronic Pain: Chronic pain lasts for 90 days or more. It’s sometimes associated with an underlying cause that has resolved, but for which pain lingers. Complex surgeries and injuries that result in permanent tissue damage can give rise to chronic pain.
We’ve also now recognize that there are genetic pain conditions like neurofibromatosis that can exist from birth. These are often not diagnosed until children are older because they lack the ability as infants to communicate about and express their discomfort. Babies and toddlers are thought to be fussy or difficult. Toddlers refuse to play or interact with others. Many of these genetic conditions result in physical and cognitive developmental delays and actually limit the life expectancy of victims.
In other pain conditions like fibromyalgia, there’s no obvious cause. But whether a cause can be identified or not, pain can last for a lifetime and even moderate, persistent pain can negatively impact sleep, the immune and other essential systems leading to a cascading series of health problems. Pain is exhausting and corrosive. People miss work, skip family events and feel isolated and misunderstood. This can lead to even more complex mental health conditions like anxiety and depression that fundamentally chip away at quality of life for the victim and those around them.
Treating Chronic Pain
While treating any pain is complex, treating chronic pain is particularly difficult because of the length of time people live with the condition. Powerful drugs still the go-to treatment for chronic pain, but drugs like gabapentinoids are only effective for a small number of people for limited periods of time. Opioids are effective at treating pain for most people, but must be carefully administered to avoid harmful side effects ranging from gastrointestinal disorders to dependence, depression and addiction. Muscle relaxants, sleeping pills, NSAIDs and a long list of prescription and over-the-counter medications crowd the medicine cabinets of the average chronic pain victim together with patches, creams, wraps and sprays – anything that can provide even temporary relief.
Pain specialists are now expanding multi-modal treatment programs to include physical therapy, acupuncture, talk therapy, diet and exercise plans and even hypnosis to help patients find some relief.
Pain Care Deserts
But in large swaths of America, there are few if any pain specialists. In fact, “pain care deserts” are an outstanding example of healthcare inequity in America. In its comprehensive review of pain treatment in America, the NIH found that just 8% of Americans even have access to pain specialists.
Primary care physicians end up with the long-term care responsibility for complex and life-limiting pain. Lacking pain specialists and treatment infrastructure like physical and occupational therapy, chiropratic and acupuncture, they are forced to prescribe the most powerful and dangerous drugs for longer periods of time. Their patients can’t afford to miss work. They also can’t fail drug tests. So physicians do what they can to legitimize prescription drug use.
Unfortunately, chronic pain patients can be substantially more vulnerable to dependency and addiction because of the ways in which chronic pain erodes its victims. Sleep loss, weakened immunity that makes people more susceptible to other diseases and infection, depression and anxiety are all byproducts of persistent chronic pain. These compound conditions make chronic pain patients in America’s poorest communities the most vulnerable to dependency and addiction.
The Cost of Chronic Pain
One CDC study and another conducted by the University of Washington concluded that at least 8% of people with chronic pain suffer from high-impact pain. That’s pain that impacts people’s lives – causing them to miss work or school, become underemployed or even unemployed or to become unable to care for themselves and others. Ironically, as a result of reduced employment, many of these people end up without health insurance, dooming them to even less access to the care they so desperately need.
Promising New Options
Those who study and treat pain are of course concerned about the healthcare industry’s continuing reliance on drugs designed to treat short-term, acute pain for treating long-term, potentially lifelong chronic pain. They’ve come to focus increasing attention on the relationship between nutrition and chronic pain and the potential for using dietary supplements to provide long-term treatment without dangerous side effects.
Among the body of promising therapeutics are plant terpenes like beta caryophyllene. Shown in numerous studies to be effective in treating neuropathy and inflammation, this particular terpene is a key, active ingredient in Nápreva.
Our focus today is on scientific and clinical research with terpenes to treat pain conditions, neuropathy and potentially even addiction. Others are studying the use of terpenes for treating various cancers, memory loss, diabetes and cardiovascular disease. But as many as 30,000-55,000 terpenes identified to date, there are endless opportunities to develop ecologically sustainable, affordable and natural products that support and improve health.
Learn More:
Overcoming Barriers: A Comprehensive Review of Chronic Pain Management and Accessibility Challenges in Rural America https://pmc.ncbi.nlm.nih.gov/articles/PMC11394986/
Prevalence of problematic pharmaceutical opioid use in patients with chronic non-cancer pain https://onlinelibrary.wiley.com/doi/10.1111/add.16616
Pathways to Equity in Pain Management https://pmc.ncbi.nlm.nih.gov/articles/PMC10457639/
Problems accessing pain care, and the adverse outcomes among adults with chronic pain: a cross-sectional survey study https://pmc.ncbi.nlm.nih.gov/articles/PMC11853623/
Overcoming Barriers: A Comprehensive Review of Chronic Pain Management and Accessibility Challenges in Rural America https://pmc.ncbi.nlm.nih.gov/articles/PMC11394986/
Chronic Pain and High-impact Chronic Pain in U.S. Adults, 2023 https://www.cdc.gov/nchs/products/databriefs/db518.htm
Nutritional Supplements for the Treatment of Neuropathic Pain https://pubmed.ncbi.nlm.nih.gov/34199290/#:~:text=So%2Dcalled%20%22nutraceuticals%22%20have,B;%20vitamin%20D;%20zinc.
Traditional Medicine Contributions to Modern Medicine https://www.who.int/news-room/feature-stories/detail/traditional-medicine-has-a-long-history-of-contributing-to-conventional-medicine-and-continues-to-hold-promise
US Veterans Administration Whole Health Library https://www.va.gov/WHOLEHEALTHLIBRARY/overviews/chronic-pain.asp
Therapeutic Applications of Terpenes on Inflammatory Diseases https://pmc.ncbi.nlm.nih.gov/articles/PMC8414653/#:~:text=In%20the%20last%20decades%2C%20the,%2Dof%2Dthe%2Dart.
