For the many years Christina Wei, 52, of Albany, Calif., suffered from back pain, she didn’t do so passively. But seeking out acupuncturists and chiropractors, experimenting with back braces and different types of mattresses — even consulting a posture specialist — never quite solved the problem. “Nothing really worked,” she says. “Or something would kind of work but only very briefly and then I’d feel the pain all over again.”
Wei’s experience is not unusual. Some 50 million — or 1 in 5 — adult Americans live with the misery and frustration of chronic pain, defined as pain that persists beyond the expected time of healing from an injury or beyond a certain duration of time, usually three to six months.
The issue can be compounded in people over 50. “They are likely to have more than one pain problem, such as osteoarthritis or pain associated with nerve injuries,” says Charles Argoff, M.D., a professor of neurology and director of the Comprehensive Pain Center at Albany Medical Center in Albany, N.Y. But chronic pain is finally getting some overdue attention, in part due to the nation’s opioid epidemic, which could lead to better ways of measuring and treating it.
Getting a handle on the hurt
It’s hard to think of pain in positive terms, but it plays a vital role in survival. “Short-term pain motivates us to escape from harm,” says Beth Darnall, a clinical professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University. “But once pain persists and becomes chronic, it is no longer a useful signal. It leads to changes in the nervous system, in our behavior and in our mood.”
Unfortunately pain also encourages people to stop moving. “Your back hurts, so you reduce your activities,” Darnall says. “This leads to deconditioning and to the worsening of pain over time.”
Yet health providers aren’t usually equipped to help people with persistent pain. Most physicians get only seven to 11 hours of pain training during medical school, says Darnall.
Plus pain is just complicated. No two people experience it the same way, and there’s no good way to measure or even describe it.
“Therapeutic decisions are based on the measurements or our understanding of the pain that a patient is experiencing,” says Daniel Lopez Martinez, a researcher at the Harvard-MIT Division of Health Sciences and Technology and the MIT Media Lab. “And currently the only way to quantify pain is to directly ask the patient, ‘On a scale of 1 to 10, how much pain are you experiencing?’ ”
Better methods may be on the way. Lopez Martinez, for instance, has devised a method of assessing pain using artificial intelligence technology to read facial expressions. Other potential rating systems rely on sensors to measure the bodily processes that often accompany pain. And scientists are delving into the brain’s contours with imaging technologies like MRIs and PET scans to find the regions and systems responsible for pain.