Biologic Factors in Chronic Pain Are Important, Too
Collecting data and analyzing it over time is called epidemiologic research. Epidemiologic studies give us the big picture. In health care, the resuls help direct patient education, prevention, and treatment for many conditions and illnesses.
In this study, findings from the last 20 years are reported on chronic pain. Here's what we know so far:
From these findings, experts suggest that chronic pain conditions are really all global on a continuum. This means it is one condition with many presentations from one end to the other. There are more similiarities than differences in patients with a global syndrome.
Research has repeatedly shown that psychologic and social variables are key to understanding chronic pain. The authors propose that biologic factors may be just as important. Neurological, hormonal, and genetic mechanisms are discussed.
New, more advanced MRIs allow researchers to view how pain is perceived and processed in the nervous system. Studies are ongoing to track differences in neurologic imaging between normal, healthy adults compared to people who have chronic pain.
Other studies are exploring the chemical and hormonal changes that take place after an injury that may alter future stress responses. And there may be a genetic component since neck and back pain tends to run in families. It remains unknown whether there is a gene for pain threshold or pain processing or this tendency is social or psychologic.
Recognizing all factors is important in finding treatment that is successful for chronic pain. Identifying risk factors may also help prevent the problem in the first place. The authors say it's likely that an interplay among all factors affects pain pathways. DNA testing, biochemical measurements, and brain imaging will help sort this all out.
Blair H. Smith, et al. Epidemiology of Chronic Pain, From the Laboratory to the Bus Stop: Time to Add Understanding of Biological Mechanisms to the Study of Risk Factors in Population-Based Research? In Pain. January 2007. Vol. 127. No. 1-2. Pp. 5-10.