The Landscape of Chronic Pain: Broader Perspectives

Abstract

Chronic pain is a global health concern. This special issue on matters related to chronic pain aims to draw on research and scholarly discourse from an eclectic mix of areas and perspectives. The purpose of this non-systematic topical review is to précis an assortment of contemporary topics related to chronic pain and its management to nurture debate about research, practice and health care policy. The review discusses the phenomenon of pain, the struggle that patients have trying to legitimize their pain to others, the utility of the acute–chronic dichotomy, and the burden of chronic pain on society. The review describes the introduction of chronic primary pain in the World Health Organization’s International Classification of Disease, 11th Revision and discusses the importance of biopsychosocial approaches to manage pain, the consequences of overprescribing and shifts in service delivery in primary care settings. The second half of the review explores pain perception as a multisensory perceptual inference discussing how contexts, predictions and expectations contribute to the malleability of somatosensations including pain, and how this knowledge can inform the development of therapies and strategies to alleviate pain. Finally, the review explores chronic pain through an evolutionary lens by comparing modern urban lifestyles with genetic heritage that encodes physiology adapted to live in the Paleolithic era. I speculate that modern urban lifestyles may be painogenic in nature, worsening chronic pain in individuals and burdening society at the population level.

Analysis of Epigenetic Age Predictors in Pain-Related Conditions

“…The personal attitude and beliefs, concerns, and fears stimulate the development of the chronic pain conditions and can restrain or totally impede the recovery, as in the case of fear-avoidance model behavior in musculoskeletal pain disorders (17). Finally, the risk factors connected to lifestyle are smoking, alcohol use disorders, limited physical activity, and painogenic modern urban environment with, for example, low sun exposure or high air pollution (18)(19)(20)(21). Additionally, the individual alimentary habits plausibly contribute to development and prevention of long-lasting pain disorders but the mechanism remains unclear (22).…”

Effect of toe exercises and toe grip strength on the treatment of primary metatarsalgia

“…In terms of the long duration of metatarsalgia, chronic pain is generally considered difficult to cure. Although there is an opinion that it is difficult to create a temporal boundary in terms of the difference between acute and chronic pain, generally, pain lasting 12 weeks or more is regarded as chronic pain [18]. The cause of pain in metatarsalgia is unclear, but it is presumed that the acute phase involves nociceptive pain.…”

Effect of toe exercises and toe-grip strength on the treatment of primary metatarsalgia

“…In terms of the long duration of metatarsalgia, chronic pain is generally considered di cult to cure. Although there is an opinion that it is di cult to create a temporal boundary in terms of the difference between acute and chronic pain, generally, pain lasting 12 weeks or more is regarded as chronic pain [18]. The cause of pain in metatarsalgia is unclear, but it is presumed that the acute phase involves nociceptive pain.…”