Reducing physical pain
Identifying and addressing highly prevalent and intensely painful conditions

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This profile is tailored towards students studying biological sciences, economics, health sciences, philosophy, psychology, however we expect there to be valuable open research questions that could be pursued by students in other disciplines.

Why is this a pressing problem?

The scale of physical pain caused by medical conditions is considerable; in the US in 2019 for example, 20% of adults reported chronic pain in the previous 3 months, with 7.4% reporting ‘high impact chronic pain’ – pain most or all days that limited their life or work activities.

Some specific physical conditions stand out as particularly important to address due to their prevalence and/or intensity. For example, pain from terminal conditions such as advanced cancer and HIV can cause intense suffering and in low and middle-income countries only 5% of the resulting need for opioids is met. HLI states that ‘cancer and HIV cause over 700 million … moderate to severe pain days.’ Lower back pain is the leading cause of years lived with disability worldwide, while migraines affect 1 in 6 people and impose a burden of disease in DALYs roughly comparable with malaria or depression. While cluster headaches affect far fewer people at 0.1-0.2% of the global population, they are particularly agonising and therefore may still be a particularly important problem to work on.

For more information see: this summary of the societal impact of headaches; this literature review on cluster headaches; this cost-effectiveness analysis of interventions for migraine in low- and middle-income countries and this review of preventative and treatment options for lower back pain. You can also watch the video below for a short explanation of cluster and migraine headaches.

Explore existing research

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If you’re interested in working on this research direction, below are some ideas on what would be valuable to explore further. If you want help refining your research ideas, apply for our coaching!

The Happier Lives Institutes’ report suggests some directions for further research (see the report for all the suggested ideas and note HLI describes these suggestions as highly preliminary):

  • What is the current state of research on novel pain agents? To what extent should this research be prioritised over improving access to existing treatments?
  • Exploration of pain-related topics not included in this review, such as other conditions that cause pain (e.g. endometriosis, trigeminal neuralgia, fibromyalgia).
  • Although lower back pain is the leading cause of years lived with disability globally it is not well understood, so explorative research could be helpful.

The Qualia Research Institute suggests that research into anti-tolerance drugs that can be taken with opioids may be useful, to prevent or lessen the degree to which patients have to take increasingly higher doses of opioids for the same effect. See here for more information.

The Happier Lives Institutes’ report suggests some directions for further research (see the report for all the suggested ideas and note HLI describes these suggestions as highly preliminary):

  • How does pain relief compare to other interventions that improve subjective well-being?
  • What is the effect of extreme pain on subjective well-being? Ideally, we would like to know the impact of pain on measures of subjective well-being [as opposed to DALYs; see here for an introduction to some issues with using DALYs] so that we can compare the impact of pain to other life events and circumstances.
  • Further research is required to determine whether drug policy reform [e.g. Increasing access to psychedelics] is a more cost-effective approach than improving access to currently legal treatments’ for cluster headaches and whether difficulty in treatment access or delay of diagnosis is the main issue in LMICs.

The Happier Lives Institutes’ report suggests some directions for further research (see the report for all the suggested ideas and note HLI describes these suggestions as highly preliminary):

  • How does pain relief compare to other interventions that improve subjective well-being?
  • Do people adapt to some kinds of pain?
  • What is the effect of extreme pain on subjective well-being? Ideally, we would like to know the impact of pain on measures of subjective well-being [as opposed to DALYs; see here for an introduction to some issues with using DALYs] so that we can compare the impact of pain to other life events and circumstances.
  • What is the current state of research on novel pain agents? To what extent should this research be prioritised over improving access to existing treatments?
  • Exploration of pain-related topics not included in this review, such as other conditions that cause pain (e.g. endometriosis, trigeminal neuralgia, fibromyalgia).
  • Further research is required to determine whether drug policy reform [e.g. Increasing access to psychedelics] is a more cost-effective approach than improving access to currently legal treatments’ for cluster headaches and whether difficulty in treatment access or delay of diagnosis is the main issue in LMICs.

The Happier Lives Institutes’ report suggests exploring how different ethical viewpoints, such as suffering-focused ethics, change individuals’ prioritisation of alleviating extreme pain. See their report for all suggested ideas, and note HLI describes these suggestions as highly preliminary.

The Happier Lives Institutes’ report suggests some directions for further research (see the report for all the suggested ideas and note HLI describes these suggestions as highly preliminary):

  • How does pain relief compare to other interventions that improve subjective well-being?
  • Do people adapt to some kinds of pain?
  • What is the effect of extreme pain on subjective well-being? Ideally, we would like to know the impact of pain on measures of subjective well-being [as opposed to DALYs; see here for an introduction to some issues with using DALYs] so that we can compare the impact of pain to other life events and circumstances.

Research from the Qualia Research Institute proposes that the extremes of physical pain are many times worse than we tend to infer from how pain intensity is reported, leading to extreme pain being more likely to be neglected. It could be valuable to carry out further empirical research on this topic, to better prioritise interventions.

Neurologist David Borsook highlights some further possible directions for research on chronic pain in this paper.

Further resources

Apply for our coaching and we can connect you directly with researchers and potentially mentors who can help you refine your research ideas. You can also apply to join our community if you’re interested in connecting with other students specifically.

Apply for our database of potential supervisors if you’re looking for formal supervision and take a look at our advice on finding a great supervisor for further ideas.

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Contributors

This profile was last significantly updated on 5/01/2022. Thanks to Joel McGuire for helpful feedback on this profile. All mistakes remain our own. Learn more about how we create our profiles.

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