Widespread, undervalued, and underestimated, despite the high incidence of chronic pain in Europe and in Italy. Prevalence is estimated at about 150 million European citizens, 1 in 5 adults, and an impact of 56% among cancer patients. Equally significant are the data in our country: chronic pain affects over 10–13 million adults (about 21.7% of the population, about 10.5 million citizens according to estimates from the Istituto Superiore di Sanità based on the EHIS (European Health Interview Survey). Important gender differences: women are the most affected, about 6.5 million compared to 4 million men, representing 60.7% of pain cases.
Another aspect not to be underestimated is the spread of pain (chronic) that grows with age, rising from 8% among 18- to 44-year-olds to over 50% in those over 85: a clinical and system-wide challenge for today and the future. Some conditions and diseases are more closely related to pain: musculoskeletal problems (60% in the last year) and headaches (54%), for example. Italy is among the few nations that protects citizens with pain through the dedicated Law 38 of 2010, which guarantees access to care, including palliative care. Data that deserve attention at all times, not only on the occasion of the European Day for Pain Awareness on October 15.
Objectives of the European Day for Pain Awareness
Promoted by the European Federation of Pain EFIC and supported in Italy by AISD (Italian Association for the Study on Pain), the day aims to raise awareness among clinical institutions, communities, and patients. The initiative’s goal is to build partnerships to refocus attention on the problem of pain and to develop actions to reduce disparities, thereby offering equitable access to care for all citizens and to timely and appropriate, sustainable treatment pathways.
The day also seeks to: fight the stigma still associated with pain, eliminating prejudices and social isolation; promote prevention by identifying and managing early modifiable risk factors to prevent acute pain from becoming a chronic and disabling condition; improve medical education so that the topic of pain is more integrated into national health strategies and into the basic and continuing training of healthcare professionals; support patients and caregivers by creating networks of support and adequate resources to improve the quality of life for those suffering and for the families who care for them.
Pain and Quality of Life
The bond between pain and quality of life is inseparable for anyone living with pain, especially for those with acute and chronic pain. The impact on daily life, autonomy, and personal freedom is severe: sleep, mobility, psychological well-being, and participation in social life are the areas most affected, with pain’s effects being highly consequential and pervasive. To protect and support patients’ needs in terms of pain control and management, key assessment tools—such as PROs (patient-reported outcomes)—play a central role, as they represent the gold standard for quantifying intensity, frequency, and the impact on daily life. They thus become a tool of fundamental usefulness for the general practitioner (GP) and for the specialist to personalize therapy, whether pharmacological or rehabilitative, based on how the patient truly perceives benefits or side effects.
In addition, PROs enable monitoring of chronic pain, especially in long-term conditions, helping to track the pain’s course over time, highlighting worsening or positive responses to treatments, and encouraging patient involvement in the care decision-making process, promoting open dialogue between physician and patient and shifting the focus from a traditional clinical model to a shared therapeutic pathway. Finally, they allow the assessment of clinical efficacy: in clinical studies and in daily practice, PROs help determine whether a treatment not only reduces physical damage but also tangibly improves quality of life (sleep, mood, mobility).
Alliance of Primary Care and Community Medicine
GPs, specialists, pharmacists, and pain therapy centers are a central axis for the early interception of patients with pain and for providing continuity of care, considering that pain management represents one of the most significant challenges for community medicine today, and especially for the future in light of the aging population.
The community-based network must be able to identify and select patients at risk of chronic pain, with particular attention to those who tend to normalize or underestimate their pain. The GP plays a key role in identifying the earliest signs of chronification, in assessing the pain’s impact on daily life, and in guiding toward appropriate specialist pathways, in alliance with the local pharmacist. Indeed, it can contribute to surfacing the need for care, thanks to frequent contact with citizens and the ability to recognize situations of prolonged self-medication or inadequate symptom control.
Ensuring continuity of care among all stakeholders is also essential, promoting effective communication and ongoing monitoring of the clinical trajectory. Therefore, an integrated and synergistic approach across different specialties and competencies is fundamental, not only to improve pain control but also to limit the consequences on quality of life. The implementation of tools and interventions proportionate to pain is strategic to preserve as fully and as well as possible sleep, functional autonomy, psychological well-being, and social participation—or any other function of the patient impaired by pain. When necessary, referring the patient to pain centers for structured and advanced care. With a single objective shared across the entire territory: to ensure continuity of care and regular follow-up for patients with pain, including those with cancer.
The Challenges of Pain in Older Adults and Longevity
As age advances, chronic pain becomes an increasingly common condition that can accelerate functional decline. Decreased mobility, fear of movement, sleep disturbances, and fatigue promote sedentary behavior, frailty, and loss of independence. Added to this is the risk of social isolation, due to pain-related limitations in participating in social activities, contributing to anxiety and depression and further compromising the overall well-being of the elderly.
Therefore the therapeutic objective of managing and addressing pain should not be solely about reducing its intensity, but about maintaining the person’s functionality and independence. In this light it is crucial to adopt a personalized approach that takes into account the numerous comorbidities often present in older adults, the risk of polypharmacy, and greater vulnerability to adverse events, designed on the basis of a multidimensional patient assessment and the integration of pharmacological and non-pharmacological strategies. The ultimate goal: to promote active aging and a better quality of life.
In the era of longevity, treating pain means above all preserving autonomy, social relationships, and functional capacity: essential elements to ensure years of healthy life and not merely an increased life expectancy.
Abbonati a Karla Miller
