The most common forms of chronic pain: Men: Lower back pain Women: Muscular pain and joint pain in the lower back, neck and shoulders The elderly: Joint pain due to osteoarthritis Around 20 percent of the population are affected by chronic pain. Source: Eva Kosek
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... no ‘magic bullet’ for all pain is in sight.
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make various choices, such as spending more time on a surface of a certain temperature than on another, or whether to drink their pain medicine. With luck, this focus on new methods will reap rewards in the form of new painkilling drugs. But no “magic bullet” for all pain is in sight, and treatments need to be designed collaboratively by teams of doctors, psychologists, social workers and physiotherapists working together. “Unfortunately the healthcare system has moved in the opposite direction, and many of the old pain clinics have closed,” says Eva Kosek. “Many patients have nowhere to go.” This situation is particularly problematic because it is patients with long-term pain who suffer most from their pain. Kosek says that many of her patients live with pain that they describe as the worst imaginable. On a scale of one to 100, they put their pain at 100 – and some even higher.
“If you ask them to draw a comparison with the pain they felt when giving birth, for example, they say that it was different, that it was very intense but also positive, so they didn’t really suffer. Their chronic pain, on the other hand, is harder to deal with because of the level of suffering.” Kosek believes that this is one of the big challenges for pain research. What is it that makes some pain cause great suffering, and how can we reduce this suffering? In a number of pioneering studies, researchers have begun to look at the differences between this long-term pain and more short-term pain in the brain. They have shown that brain activity connected with long-term pain is concentrated in parts of the brain that deal with cognitive functions and emotions, with hardly any activity in the parts involved in short-term pain perception. “With chronic pain there’s so much more going on than when you hit your hand, say, and as yet we understand very little about it,” says Kosek. F m e d i ca l s c i e n c e • e n g li s h la n g uag e e d i t i o n 2012 17