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Alleviating Suffering 101 — Pain Relief in the United States
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An Institute of Medicine committee has found that the magnitude of pain in the United States is vast — and costly. It concluded that relieving acute and chronic pain is a significant overlooked problem and that education is key to the cultural transformation required.
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“the economic burden of pain in the United States was estimated to be $560-635 billion in 2012.10”
From Pain and Evil: From Local Nociception to Misery Following Social Harm (2020) · cites this paper as [10]
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Regulation of pain by neuro-immune interactions between macrophages and nociceptor sensory neurons
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“Chronic pain is a clinical epidemic, affecting more than 30% of adults with costs exceeding $600 billion dollars annually in the United States [4].”
BackgroundManchikanti, L., Abdi, S., Atluri, S. L., Balog, C. C., Benyamin, R. M., Boswell, M. V., Brown, K. R., Bruel, B. M., Bryce, D. A., Burks, P. A., et al. (2012) · PubMed · Cited by 243
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Effective Pain Management and Improvements in Patients’ Outcomes and Satisfaction
Glowacki, D. (2015) · Critical Care Nurse · doi:10.4037/ccn2015440 · Cited by 200
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Neuroinflammation, Bone Marrow Stem Cells, and Chronic Pain
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“Chronic pain costs the US economy more than $600 billion per year in healthcare expenditures, disability payments, and lost productivity (from American Pain Society) (2).”
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“Chronic pain is an enormous unmet medical need with a multi-billion dollar impact on society (Pizzo and Clark, 2012).”
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Manchikanti, L. (2018) · Pain Physician · doi:10.36076/ppj.2018.4.309 · Cited by 140
“Hamburg spoke of “100 million Americans suffering from severe chronic pain,” which became a central part of the debate used to justify Zohydro’s approval (61-63).”
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Hansen, H. (2012) · Pain Physician · doi:10.36076/ppj.2012/15/e247 · Cited by 139
Manchikanti, L., Abdi, S., Atluri, S. L., Balog, C. C., Benyamin, R. M., Boswell, M. V., Brown, K. R., Bruel, B. M., Bryce, D. A., Burks, P. A., et al. (2012) · PubMed · Cited by 129
Nitroxidative signaling mechanisms in pathological pain
Grace, P. M., Gaudet, A. D., Staikopoulos, V., Maier, S. F., Hutchinson, M. R., Salvemini, D., & Watkins, L. R. (2016) · Trends in Neurosciences · doi:10.1016/j.tins.2016.10.003 · Cited by 128
“Normalizing nitroxidative signaling may be an alternative strategy to help to alleviate the enormous burden of pathological pain, which affects 20% of the population and is poorly treated [11,193,194].”
Why Doctors Prescribe Opioids to Known Opioid Abusers
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“Figure S7 WHO I drug studies with high level of evidence: SMDs between pain scores (0–100) in treatment (analgesic) and placebo groups at study end, based on published (Pizzo and Clark, 2012) or imputed (i) data.”
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“Current research by the Institute of Medicine (IOM) estimates that chronic pain affects approximately 100 million individuals in the United States (US) and has an estimated societal impact between $560 and $635 billion annually in direct medical treatment costs and lost productivity.(1) Chronic pain, particularly when…”
BackgroundResultInfluentialEffect of Minocycline on Lumbar Radicular Neuropathic Pain
Vanelderen, P., Zundert, J. H. M. V., Kozicz, T., Puylaert, M., Vooght, P. D., Mestrum, R., Heylen, R. J., Roubos, E. W., & Vissers, K. C. P. (2014) · Anesthesiology · doi:10.1097/aln.0000000000000508 · Cited by 88
State Medical Marijuana Laws and the Prevalence of Opioids Detected Among Fatally Injured Drivers
Kim, J. H., Santaella-Tenorio, J., Mauro, C., Wrobel, J., Cerdá, M., Keyes, K. M., Hasin, D. S., Martins, S. S., & Li, G. (2016) · American Journal of Public Health · doi:10.2105/ajph.2016.303426 · Cited by 88
An Update of the Systematic Assessment of the Diagnostic Accuracy of Lumbar Facet Joint Nerve Blocks
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Kovačević, I., Pavić, J., Filipović, B., Vulinec, Š. O., Ilić, B., & Petek, D. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21091135 · Cited by 121
Chronic pain treatment with opioid analgesics: benefits versus harms of long-term therapy
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A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions.
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Minocycline as a promising therapeutic strategy for chronic pain.
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mTOR, a New Potential Target for Chronic Pain and Opioid-Induced Tolerance and Hyperalgesia
Lutz, B. M., Nia, S., Xiong, M., Tao, Y., & Bekker, A. (2015) · Molecular Pain · doi:10.1186/s12990-015-0030-5 · Cited by 73
Paul-Savoie, É., Bourgault, P., Potvin, S., Gosselin, É., & Lafrenaye, S. (2018) · Pain Research and Management · doi:10.1155/2018/6375713 · Cited by 72
“People with chronic pain are known to consult health professional frequently, leading in a heavy economic burden [3, 4].”
Manchikanti, L., Singh, V. P., Cash, K. A., Pampati, V., & Falco, F. J. E. (2012) · Pain Practice · doi:10.1111/papr.12023 · Cited by 70
Schreiber, J. A., Cantrell, D., Moe, K. A., et al. (2013) · Pain Management Nursing · doi:10.1016/j.pmn.2012.12.006 · Cited by 69
mTOR Kinase: A Possible Pharmacological Target in the Management of Chronic Pain
Lisi, L., Aceto, P., Navarra, P., & Russo, C. D. (2015) · BioMed Research International · doi:10.1155/2015/394257 · Cited by 71
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Predictors of Pain Among Patients With Head and Neck Cancer
Shuman, A. G., Terrell, J. E., Light, E., Wolf, G. T., Bradford, C. R., Chepeha, D. B., Jiang, Y., McLean, S. A., Ghanem, T., & Duffy, S. A. (2012) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/jamaoto.2013.853 · Cited by 66
“Pain, more than any other symptom or disease, is the single greatest source of financial expense and patient complaints in America.63 Reducing the potential for pain from neck dissection, minimizing xerostomia, and using evidence-based strategies for effective analgesia are opportunities worth considering in order to…”
Hush, J. M., Nicholas, M. K., & Dean, C. M. (2018) · PAIN Reports · doi:10.1097/pr9.0000000000000645 · Cited by 61
“Institute of Medicine (2012) stated that a major impediment to adequate pain relief was patients’ limited access to clinicians who are knowledgeable about pain, which was related to the prevalence of outmoded or unscientific knowledge and attitudes about pain.(19) In response, several recommendations have been made to…”
BackgroundMurinson, B. B., Gordin, V., Flynn, S., Driver, L., Gallagher, R. M., & Grabois, M. (2013) · Pain Medicine · doi:10.1111/pme.12051 · Cited by 61
Identification of A3adenosine receptor agonists as novel non‐narcotic analgesics
Janes, K., Symons-Liguori, A. M., Jacobson, K. A., & Salvemini, D. (2016) · British Journal of Pharmacology · doi:10.1111/bph.13446 · Cited by 59
“…drugs (NSAIDs), antidepressants, anticonvulsants and opioid pain relievers; however, these strategies are frequently either inadequate or are associated with side effects that reduce quality of life or result in the discontinuation of therapy (Goldberg and McGee, 2011; Pizzo and Clark, 2012).”
BackgroundAn Update of the Systematic Assessment of Mechanical Lumbar Disc Decompression with Nucleoplasty
Manchikanti, L. (2013) · Pain Physician · doi:10.36076/ppj.2013/16/se25 · Cited by 57
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Neuroimmune modulation of pain and regenerative pain medicine
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Brief Pain Inventory–Short Form: A New Method for Assessing Pain in the Emergency Department
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BackgroundInterleukin-17 as a potential therapeutic target for chronic pain
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“Chronic pain is projected to impact 37% of Americans by 2030, creating an additional economic burden of $635 billion (3, 4).”
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Cellular and Molecular Mechanisms of Calcium/Calmodulin-Dependent Protein Kinase II in Chronic Pain
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“In addition to significantly affecting patient quality of life, chronic pain has a high economic burden (Crown, 2012; Pizzo and Clark, 2012; Zhou et al., 2016a).”
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An Update of the Appraisal of the Accuracy and Utility of Cervical Discography in Chronic Neck Pain
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“drugs, antidepressants, or anticonvulsants) are frequently inadequate or associated with adverse side effects.(7,18,43) Therefore, new therapeutics for managing patient pain are being developed.”
BackgroundAn update of the effectiveness of therapeutic lumbar facet joint interventions.
Falco, F. J. E., Manchikanti, L., Datta, S., Sehgal, N., Geffert, S., Onyewu, O., Zhu, J., Coubarous, S., Hameed, M., Ward, S. P., et al. (2012) · PubMed · Cited by 46
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Dynamic Quantitative Sensory Testing to Characterize Central Pain Processing
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“Chronic pain is a significant problem in the United States, affecting more than 100 million American adults at a cost upwards of $635 billion per annum.(1) Due to the subjective nature of pain, it is difficult for researchers and clinicians to objectively measure a person's painful experience(s), therefore making it c…”
BackgroundOpioid Prescriptions by Specialty in Ohio, 2010–2014
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Integrative Care for Pediatric Patients with Pain
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Gene therapy for chronic pain management
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“The etiology of CWP is complex and poorly understood, but CWP has been shown by several groups to be heritable with heritability estimates usually exceeding 30%.(34,48) Of the many risk factors that have been proposed for CWP, increased bodymass index (BMI) is one of the strongest and most consistently reported.”
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“Approximately one-third of Americans suffer from chronic pain, and this proportion is increasing.(41,43) Chronic pain, including neuropathic pain fromperipheral nerve injury, is frequently treated with opioids.”
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“[18] Inadequate knowledge concerning managerial skills and pain assessment[19] and wrong understanding of various professional health caregivers, especially the nurses, have been mentioned as efficient managerial barriers in adequate pain management.[20] Therefore, as pain management is essential for appropriate care…”
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“The combination of two factors related to coping with this problem gives surgery an additional importance: (1) ineffective existing treatments of neuropathic pain and (2) the importance of surgical techniques avoiding nerve injuries in the prevention of this type of chronic pain.”
InfluentialKynurenine Pathway Metabolites as Potential Biomarkers in Chronic Pain
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“The economic burden that chronic pain places on the United States exceeds the amount spent on the country’s preeminent health conditions of diabetes, cancer, and cardiovascular disease combined [5].”
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“Only in the United States, more than half of patients with pain have reported inadequate treatment of their condition [55], and this percentage is even higher in low- and middle-income countries [9].”
BackgroundFuture Directions for Pain Management
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Metadata
- Authors
- Pizzo, P. A., & Clark, N. M.
- Affiliations
- Stanford Medicine (US)
- University of Michigan (US)
- ORCID
- Pizzo, Philip A.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2012-01-19
- Volume
- 366
- Issue
- 3
- Pages
- 197-199
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2072724964
- Cited by
- 231
- References
- 0
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 9 · 2023: 13 · 2022: 10 · 2021: 16 · 2020: 16 · 2019: 12 · 2018: 17 · 2017: 16 · 2016: 16 · 2015: 25 · 2014: 20 · 2013: 21 · 2012: 27
- FWCI
- 40.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
- Keywords
- analgesia, chronic pain, acute pain, pain management, Institute of Medicine report, pain education, cultural change, health care costs, United States
- MeSH terms
- Clinical Competence, Education, Medical, Humans, United States, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division, Advisory Committees, Chronic Pain, Pain Management
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