What is happening is nothing short of a revolution. “Previously, doctors wanted to end pain by healing the underlying problem. Now we think it’s important to treat the pain at the same time that we treat the underlying illness,” says Dr. Simon, a co-author of the APS guidelines. Biochemical research, genetic research and imaging technologies have catalyzed remarkable studies, the results of which are contributing to the development of new diagnostic methods and treatment options. “This next decade is going to be a golden era of pain therapies,” Dr. Simon says. That means more pain research will lead to new and better treatments.

On a fundamental level, researchers now understand that different diseases produce different kinds of pain and that pain is an individual and subjective experience. The pain from osteoarthritis (OA) is different from postoperative pain, for example. “Pain is not homogenous,” according to Clifford Woolf, MD, PhD, professor of anesthesia research at Harvard Medical School.

This conceptual shift has huge implications for pain treatment in the next decade being targeted to address the specific kind of pain a patient may be feeling, says Dr. Woolf. “We know it will be very unlikely that one magic bullet will be useful for all pain. Instead we need to identify an individual patient’s pain, determine which mechanisms are the predominant cause of their pain and target treatment to those mechanisms.”

Another shift in perspective has come with the recognition that pain does not arise only in the periphery of the body, such as limbs and joints, but can also arise from changes within the central nervous system (CNS), says Dr. Woolf. You may blame your condition for your pain, but what if the real culprit was your genes, your brain or your very nerves? Pain has long been thought of as a symptom of conditions affecting those areas of the body, but an emerging new way of thinking may attribute the occurrence of some of those conditions to the pain signals coursing through your nervous system.

Why You Hurt

Don’t you wonder why you hurt and what pain does to your body? To really understand what’s going on in pain research, you need to know a little about the nervous system, which can seem as daunting as the electrical flow chart of a complex power grid. The entire nervous system has two main divisions: central and peripheral. The CNS consists of your brain and spinal cord. The peripheral nervous system (PNS) consists of everything else – all the nerves that project from the brain and spinal cord to the trunk and limbs, which are on the “periphery” of your body.