Researchers and clinicians are studying, comparing diverse know-how, and evaluating the possibility of integrated approaches in the treatment of chronic pain, an issue affecting 14 million people in Italy alone. With the aim of delivering concrete answers to chronic pain, which is highly impactful on disability, physical, mental, and emotional well-being, and on quality of life, the NexPain Congress was held in Milan. A forum that gave voice to national and international experts from varied training and backgrounds—pain therapists, oncologists, pharmacologists, nurses, palliative care specialists—to address chronic pain from a multidisciplinarian and multisystemic perspective to tackle chronic pain in a multidisciplinary and multisystemic view.
The Prospects
Digital medicine, tools of Artificial Intelligence (AI), telemedicine, augmented reality and virtual reality, mini-invasive technologies, e-health, innovative pharmacological therapies, neuromodulation, medical cannabis, psychedelics, and lifestyle education—primarily dietary—are among the options examined during the event to set up innovative, integrated, and personalized care pathways based on the intensity, manifestations, and duration of pain: a new management approach and vision, potentially more effective and targeted, to try to alleviate the daily limitations that crosswise affect physical, mental, and emotional well-being of the pain patient, with the possibility of bringing these treatments closer to people, even at home.
«Today we have a wide range of increasingly customizable therapeutic options—said Vittorio Guardamagna, director of the Palliative Care and Pain Therapy Division at the European Institute of Oncology (IEO) in Milan and President of the Congress—but they can be modulated according to the concept and goals of precision medicine, a reality that is now established in pain therapy as in oncology and beyond. In particular the new technologies—from e-health to AI—are transforming the hospital-centered paradigm, enabling clinicians to monitor patients at home. This facilitates doctor-patient dialogue, strengthens the empowerment of the person and their family, and contributes to better health outcomes. Thanks to innovation and new synergies we want to build a future in which pain is treated more effectively and humanely.
There is also a strong response to the numbers: it is estimated that across the country one in four adults suffers from chronic pain, a condition that persists over time, reshaping the neural pathways along which pain travels and turning pain itself into a disease, often associated with depression, anxiety, and social isolation. Chronic pain affects, for example, about 50% of cancer patients, 1.5 million Italians, and can be linked to the cancer itself and/or the treatments received. These figures, patients’ tolerability challenges, and the limited effectiveness of current therapies are challenging areas for research and clinical practice, which pursue the goal of controlling cancer-related chronic pain and restoring the patient to a state of well-being or recovery.
Communication and Information in the Fight Against Pain
«The concept of health is evolving: patients are more informed but must navigate through infodemic and fake news, therefore the treatment of pain also requires cultural work to overcome stigma and fears—clarified Grazia Armento, head of the Pain Therapy and Palliative Care Unit Research at IEO and Scientific Director of the Congress. It is necessary to clarify the therapeutic value of established drugs such as fentanyl, a cornerstone in cancer pain management, made even safer by innovative devices that prevent improper use.
The Conference
The event brought together specialists from diverse fields, a necessary cultural osmosis to address pain in all its complexity, avoiding fragmentation of care and ensuring continuity of care and multidimensionality, held in consideration that chronic pain affects not only the individual but also the social-relational dimension of the person, their habits and lifestyle.
«Pain—continues the professor—is an experience that involves the entire psycho-physical dimension of the person: in oncology, for example, pain and malnutrition are closely linked and can influence clinical outcomes. For this reason, targeted nutritional counseling, inspired by the Mediterranean diet, is an integral part of the therapeutic pathway tailored to the person’s needs, even before they become a patient with pain».
