US Pharm. 2022;47(3):14.

The National Institutes of Health notes that pain is the most common reason for seeking medical care. In addition to pharmaceuticals and nutraceuticals, people turn to complementary and integrative health approaches for relief from pain. In 2017, according to the National Health Interview Survey, 17% of adults experienced severe pain and 11% of adults had daily pain. In 2011, the Institute of Medicine (now the National Academy of Sciences [NAS]) reported that more than 100 million adults experienced chronic pain, and other studies have shown that 25 million adults had daily pain, 10 million had high levels of pain, and 8 million suffered from pain severe enough to interfere with their lives. The annual cost of health care—including lost productivity due to pain—approximated $600 billion, with missed workdays costing $13 billion and lost work hours costing $97 billion, according to the NAS.

Nonpharmaceutical Research: This type of research focuses on psychological and/or physical approaches to pain management. To obtain pain relief, 3 million adults used acupuncture, 4.2 million used yoga, 15.4 million used massage therapy, and 29.7 million used meditation. Nontraditional methods were also used for pain management in children and adolescents aged 4 to 17 years, including massage (385,000 individuals), meditation (4 million), and yoga (4.5 million).

Characteristics and Type of Research: A systematic review by the Agency for Healthcare Research and Quality found increased evidence that nondrug approaches such as acupuncture, hypnosis, massage, mindfulness meditation, spinal manipulation, tai chi, and yoga may help manage some painful conditions. In some instances, such approaches provided temporary relief rather than a cure. The National Center for Complementary and Integrative Health supports, conducts, and funds pain research, as do the Department of Defense and the Department of Veterans Affairs, which have funded 4% and 5%, respectively, of research. In federally funded research on pain mechanisms and treatment, 20.4% of studies chiefly focused on neurologic/glial aspects, 7.3% examined nondrug approaches, and 5.9% investigated biobehavioral and psychosocial aspects. Although training for pain management was included in only 7% of studies, all study protocols addressed basic (40%), clinical (42%), and translational (18%) aspects of research.

Research Themes: Overarching pain-research themes in 2011 included pain mechanisms (42%), basic-to-clinical (11%), disparities (10%), training and education (10%), tools and instruments (8%), and surveillance and human trials (5%). Among the topics of studies related to disparities were health and access to care (10%); sex and gender (12%); women’s and minority health (14%); substance use and abuse/addiction (19%); and specific patient populations, such as elderly, end-of-life, disabled, and military (45%).

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