About this Research Topic
Decades of multidisciplinary research have dramatically advanced our understanding of the mechanisms underlying chronic pain. For instance, studies in both humans and rodents have revealed how neural circuit adaptations are critical for persistent pain and pain-like behaviors. These mechanistic insights hold promise for developing novel therapies that could prevent acute pain from becoming chronic or even relieve existing chronic pain.
To evaluate treatment efficacy in randomized controlled trials, it is essential to operationalize “chronic pain.” Recently, an NIH Task Force provided a working definition to distinguish acute pain from chronic pain, defining chronic pain as pain experienced on at least half of the days over the past six months. However, this definition arguably leaves much to be desired. Several questions arise when defining “chronic pain,” such as:
1. Duration vs. Intensity and Frequency: Should chronic pain be defined solely by its duration as per the NIH Task Force definition, or should we also consider aspects such as intensity and temporal dynamics (e.g., frequency)?
2. Mechanistic Parameters: Should we incorporate mechanistic parameters, including peripheral and central contributors, alongside nociceptive, neuropathic, and nociplastic “types” of pain?
3. Condition-Specific Definitions: Can chronic pain be defined uniformly across different conditions, or do we need separate criteria for head pain, body pain, visceral pain, cancer pain, etc.?
4. Individual-Level Definition: Can we define the transition to, existence of, or recovery from chronic pain at the single-subject level?
5. Overcoming Binary Limitations: How can we address the negative consequences of defining chronic pain as a binary state? For example, the information loss / statistical inefficiency associated with binarizing outcomes, along with conceptual issues like Sorites paradox—why should one day determine the classification between acute and chronic pain?
6. Alternative Classifications: What benefits would arise from differentiating acute from chronic pain rather than using, for example, a continuum or another dimension for classification?
7. Concept versus Construct: Rather than a construct, is chronic pain better described as a concept that is not yet well-defined for operationalization?
8. Ontological Basis: What is the ontological basis for “chronic pain”? In other words, should “chronic pain” be considered a real, discrete entity that actually exists rather than a contrived definition or categorization, and if so, why?
In this Research Topic, we invite colleagues to explore these issues from various scientific, clinical, and psychometric perspectives. We hope that this collection will help chart new directions for how we define and operationalize “chronic pain,” if at all.
To evaluate treatment efficacy in randomized controlled trials, it is essential to operationalize “chronic pain.” Recently, an NIH Task Force provided a working definition to distinguish acute pain from chronic pain, defining chronic pain as pain experienced on at least half of the days over the past six months. However, this definition arguably leaves much to be desired. Several questions arise when defining “chronic pain,” such as:
1. Duration vs. Intensity and Frequency: Should chronic pain be defined solely by its duration as per the NIH Task Force definition, or should we also consider aspects such as intensity and temporal dynamics (e.g., frequency)?
2. Mechanistic Parameters: Should we incorporate mechanistic parameters, including peripheral and central contributors, alongside nociceptive, neuropathic, and nociplastic “types” of pain?
3. Condition-Specific Definitions: Can chronic pain be defined uniformly across different conditions, or do we need separate criteria for head pain, body pain, visceral pain, cancer pain, etc.?
4. Individual-Level Definition: Can we define the transition to, existence of, or recovery from chronic pain at the single-subject level?
5. Overcoming Binary Limitations: How can we address the negative consequences of defining chronic pain as a binary state? For example, the information loss / statistical inefficiency associated with binarizing outcomes, along with conceptual issues like Sorites paradox—why should one day determine the classification between acute and chronic pain?
6. Alternative Classifications: What benefits would arise from differentiating acute from chronic pain rather than using, for example, a continuum or another dimension for classification?
7. Concept versus Construct: Rather than a construct, is chronic pain better described as a concept that is not yet well-defined for operationalization?
8. Ontological Basis: What is the ontological basis for “chronic pain”? In other words, should “chronic pain” be considered a real, discrete entity that actually exists rather than a contrived definition or categorization, and if so, why?
In this Research Topic, we invite colleagues to explore these issues from various scientific, clinical, and psychometric perspectives. We hope that this collection will help chart new directions for how we define and operationalize “chronic pain,” if at all.
Keywords: Chronic Pain
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