New Approaches to the Treatment of Chronic Pain: Pharmacological and Non-Pharmacological Methods
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Abstract
Chronic pain is a complex, multifactorial disease that affects approximately 20–25% of the global adult population, leading to significant disability and economic burden. The pathophysiology of chronic pain involves central sensitization, neuroinflammation, and maladaptive neural plasticity, with genetic and epigenetic factors influencing individual susceptibility. Despite advancements in pain management, current treatments remain symptomatic, with limited efficacy in addressing underlying mechanisms. Pharmacological approaches, including opioids, NSAIDs, antidepressants, and anticonvulsants, primarily target nociceptive pathways and neuroinflammation but come with side effects and risks. Non-pharmacological methods such as Cognitive Behavioral Therapy (CBT), mindfulness, physical therapy, acupuncture, and neuromodulation therapies, offer complementary or alternative approaches by focusing on modifying pain perception and neuroinflammation. CBT and mindfulness-based interventions have shown efficacy in addressing both pain intensity and emotional distress, while physical therapy aims to restore functional mobility. Acupuncture and traditional herbal remedies provide analgesic effects through modulation of neural pathways and inflammation. Neuromodulation techniques, such as spinal cord stimulation and transcranial magnetic stimulation, offer promising results in chronic pain management. This review explores the latest pharmacological and non-pharmacological approaches to chronic pain, highlighting their mechanisms and therapeutic potential in improving patient outcomes and quality of life.