The chronic pain condition represents a substantial burden on public health, and yet it is still too often underestimated. In Italy the ailment affects about 13 million people, roughly one in four citizens; however, its management remains uncertain. A precise snapshot of this situation comes from a national survey recently published in BMC Health Services Research, based on the responses of 492 patients.
Key findings
The study, conducted between October 31 and November 11, 2025, using the CAWI methodology, involved adult patients with chronic pain lasting at least 3 months with a highly balanced gender distribution (53% women, 47% men). Regarding the clinical profile, musculoskeletal conditions represented the primary source of pain (57%), followed by chronic inflammatory and autoimmune diseases (17%), neuropathic or neurological conditions (9%), cancer-related pain (3%), and idiopathic or complex pain syndromes (2%).
The average pain intensity reported in the past week was 6.2 ± 1.8 on a 0-10 NRS scale, with 52% of participants reporting severe pain (NRS 7-10) and 40% reporting moderate pain (4-6). Nonetheless, 28% of the sample indicated that they did not receive any specific therapy for pain management. Yet this is a condition that markedly affects daily life, as it significantly impacts sleep quality (74.8%), work and study (75.5%), caregiving (64.1%), and personal care (51.9%).
Difficulties in navigating care and shortages of specialists
The survey highlights limited access to specialized care and, more generally, a lack of continuity. Among patients receiving treatment, initial prescriptions were issued by primary specialty clinicians (44.1%), general practitioners (42.9%), and only in 13% of cases by pain management specialists. Moreover, only 22% of those initially managed by a pain specialist continued to be followed by that specialist.
More broadly, only 4% of participants are currently followed by a pain specialist, while a substantial 40% rely on their family doctor, 26% on a specialist for the underlying condition, and 18% on a physical therapist. It is noteworthy that 9% reported having no professional point of reference for pain management.
71.7% report difficulties finding competent specialists and 65.4% report a lack of clear information about the care pathway.
Perceptions of primary care and care coordination
Interprofessional collaboration proves inefficient for most respondents: 48.5% consider communication between the general practitioner and the specialist inadequate, while 48.6% judge overall collaboration as poor. Although the family physician remains the main point of contact, 65.6% of participants deem him competent in managing pain (compared with 89.8% for organ specialists).
Additionally, 44.1% feel their general practitioner views chronic pain as a secondary issue. The authors emphasize the need to bolster general practice training to enable early diagnosis, embrace a biopsychosocial approach, and improve referral pathways to higher-level services.
Limited awareness of Law 38/2010 and barriers to opioids and cannabinoids
Although Law 38/2010 protects the right to pain therapy, patients’ awareness of the regulation remains marginal: only 7.5% report knowing it in depth, 53.3% have superficial knowledge, and 39.2% do not know it at all.
Furthermore, 47.6% of participants cannot distinguish pain therapy from palliative care. Regarding advanced therapy options, 58.8% perceive access to opioid or cannabinoid therapies as difficult. The main barriers are regulatory constraints (58%), reluctance of prescribing physicians (54.9%), and bureaucratic/administrative obstacles (47.8%).
Institutions and unexpressed patient needs
The data reflect a marked sense of isolation: 74.5% of participants believe that chronic pain is not adequately addressed in public discourse, 80.5% consider it underrepresented in the media, and 67.2% say they do not feel supported by the National Health Service.
Moreover, 65.9% note that pain is still primarily interpreted as a simple symptom rather than as a disease in its own right. Among the information most requested are locating centers and specialist services (51.6%), guidance on lifestyle changes (41%), details on medications and their side effects (39.6%), exemptions from co-pays (38.6%), and non-pharmacological approaches or therapies (36.9%).
Prospects and limitations of the survey
While the survey details a grim portrait, the authors themselves highlight several limitations, beginning with the use of an online survey (CAWI), which may have partially excluded populations with limited digital literacy, the cross-sectional nature of the study, and reliance on self-reported diagnoses and pain levels without direct clinical confirmation.
In conclusions, the research calls for regulatory reforms, public information campaigns, the strengthening of multidisciplinary clinical pathways, and potential supplementary support from digital health (such as biosensors or dedicated apps) to convert the guarantees of the law into services and rights that are actually accessible to patients.
Source
Consoletti, L., Gentili, M., Giacomelli, L. et al. Chronic pain in Italy: exploring patient perspectives on care gaps and opportunities. BMC Health Serv Res (2026). https://doi.org/10.1186/s12913-026-15505-y
Subscribe to Integrative Medicine
