Title: Pain Therapy Centers in Italy Strive to Alleviate Chronic Pain and Improve Quality of Life
Subtitle: Recognizing the Importance of Diagnosis and Treatment in Managing Pain
MILANO – Pain serves as the body’s signal that something is wrong, and it is an experience that everyone encounters at some point. During childhood, minor injuries teach us about our physical boundaries, but as we age, pain can become more elusive, leaving us wondering about its origins and how to find relief. In Italy, pain therapy centers have emerged to analyze and understand the origin of pain, as well as develop effective treatments for chronic and acute pain symptoms.
Dr. Milena Racagni, an expert in pain therapy, defines pain therapy as the discipline of medicine that focuses on diagnosing and treating patients with acute pain symptoms, as well as chronic benign or malignant conditions. This multidisciplinary approach is particularly relevant in the case of neuropathic pain, which results from abnormal stress on the central and peripheral nervous systems. Chronic pain, affecting around 13 million Italians and 150 million Europeans, remains a vastly underrepresented condition in the healthcare and social fields. In Italy, chronic pain prevails in 21.7% of the population, with significant disparities between regions in terms of access to care and treatments.
It is crucial that pain is approached correctly, both in terms of diagnosis and therapy, to prevent its chronicity. In recent years, specialized Pain Therapy Centers have been established, allowing patients to access them upon referral from a general practitioner or specialist. However, recognizing the very existence and cause of pain can be challenging for individuals, leading to significant consequences in their daily lives. Furthermore, as the body ages, various pains can arise, impacting one’s quality of life. The transition from acute to chronic pain can be immensely challenging for patients, making it difficult for them to adhere to long-term or lifelong treatment plans.
Chronic pain is defined as persistent, continuous, or recurring pain lasting for more than three months. Unlike acute pain, which is directly caused by a specific injury or disease, chronic pain itself becomes a disease if left untreated. Consequently, managing chronic pain requires a multidimensional approach guided by specialists. Self-management often leads to delays in diagnosis and compromised therapeutic outcomes. Patients suffering from chronic pain should seek the care of pain therapist doctors, who have various treatment options at their disposal, including nonsteroidal anti-inflammatory drugs (NSAIDs), neuromodulators, and opioids. Unfortunately, patients are frequently hesitant to use opioids due to concerns about addiction.
Psychoeducation and exploring alternative therapies allow patients to recognize that chronic pain is treatable, enabling them to live with it while maintaining a good quality of life. Continuous scientific research aims to deepen the understanding of pain mechanisms and develop more effective remedies. For example, research has found that repetitive stimulation of peripheral nerve receptors can trigger inflammatory responses, lowering the pain response threshold and leading to chronic (neuropathic) pain.
Neuromodulation techniques, such as Percutaneous Electrical Nerve Stimulation (PENS) or Pulsed Radiofrequency (PRF), can offer interventions that interfere with the mechanisms responsible for neuropathic pain. These techniques involve the use of special needle probes inserted into specific sensory nerve branches, delivering targeted energy to induce pain relief.
With an aging population, prioritizing quality of life becomes increasingly important in Italy. Modern lifestyle factors, such as stress, anxiety, and sedentary habits, contribute to the growth of pain-related conditions. The COVID-19 pandemic’s stress and social isolation have also played a significant role in shaping our approach to pain. Limited access to treatment during the pandemic and personal experiences are potential contributors to the development of pain disorders. Consequently, older individuals require more comprehensive care involving family members and caregivers to ensure successful pain management.
In pain therapy centers, various conditions can be treated, including spine-related pathologies, postoperative outcomes, neuralgia, neuropathic pain, chronic neoplastic pain, pain in osteoporosis, fibromyalgia syndrome, trauma-related outcomes, outcomes of radiation therapy, and connective tissue diseases. Pain therapy encompasses both pharmacological and invasive treatments. Teamwork is crucial in this discipline, involving specialists such as physiatrists, physiotherapists, neuroradiologists, rheumatologists, orthopedists, and neurosurgeons. Anesthesia-trained pain specialists coordinate these efforts.
The biopsychosocial impact of pain must be considered in patient care, emphasizing the importance of collaboration with clinical psychologists. In Milan, the RED (Network for Pain Therapy) was established, bringing together pain therapy centers across the metropolitan area. General practitioners can refer patients to specialized pain treatment centers within the RED network, aiming to enhance accessibility for adult and pediatric patients.
As the field of pain therapy continues to advance, the hope is that more individuals suffering from chronic pain will receive the necessary care and support to manage their condition, enabling them to lead fulfilling lives with improved quality.