Guest Voices: Dr. Shai Gozani of NeuroMetrix On Thinking Beyond a “one size fits all” Approach to Treating Chronic Pain
As it stands, more than 1.5 billion people worldwide suffer from chronic pain. And while the United States spends $600 billion annually on the direct and indirect costs of chronic pain, more than half of people with chronic pain report inadequate pain control. The numbers are alarming.
This is especially important to be aware of when thinking of older adults, where the prevalence of chronic pain is highest. Since the bulk of our national health care spending is on this age group, both the potential impact on lives and economy is massive.
I’d argue that one of the primary reasons for America’s struggle with treating pain is not any one component, it is the one-size-fits-all approach.
Chronic pain is a complex biopsychosocial condition, which means that it involves the interplay of biological (e.g., tissue damage, disease, genetics), psychological (e.g., anxiety, depression) and social (e.g., cultural, financial, access to care) factors. As such, chronic pain is a uniquely personal condition that affects each sufferer differently. For some, the primary issue is the direct experience of pain – the pain intensity. However, for most, the impact of chronic pain is felt through its deterioration of quality of life, such as sleep, activity, mood and general health.
Because of this, a one-size-fits-all approach (meaning a single treatment method often prescribed by a doctor) may be destined to fail. This method of treating patients, often in the form of prescription pain medications (e.g. opioids) does not address the unique and complex profile of the individual person, and often comes with undesirable side effects. Instead, treatments should be adjusted accordingly – especially for the 50+ population that is seeking to maintain a high quality of life with fewer medications.
To do this, health technology innovators will play a big role in changing how chronic pain is treated.
To start, a key piece to the puzzle is digital medicine. A good example of this is the growing approach of precision medicine, which is defined as “a medical model that proposes the customization of healthcare, with medical decisions, practices, and/or products being tailored to the individual patient.” Precision medicine has the ability to tailor the solution to the individual, incorporating conventional treatments that are appropriate for each patient.
In addition, we need to innovate and bring awareness to alternative and supplemental options so those with chronic pain – and their doctors – are not relying on a one-size-fits-all treatment. Take, for example, non-narcotic/non-pharmacological treatments, such as neurostimulation wearables like Quell, or cognitive behavioral therapy and physical therapy. Despite the prevalence of chronic pain, many people are unaware of the growing number of the options available to them.
Such drug-free options are especially critical in today’s regulatory landscape where it is becoming increasingly difficult for people living with chronic pain to gain access to prescription medications as well as for those in the 50+ age group who prefer fewer medications. While technologies like wearables might seem more targeted to younger people suffering from chronic pain, the older adult market is willing to explore technology solutions to help them maintain their desired lifestyle.
Moving forward, we need to start to think of chronic pain treatment as a combination of therapies to maximize relief for the older adult market where chronic pain is on the rise. In doing so, I encourage health technology innovators to think of ways to treat chronic pain, focusing on a “toolbox” approach that marries precision medicine with non-pharmacologic therapies.
From there, we can then break the vicious cycle of chronic pain, where pain is no longer in the driver’s seat. The end result? People with chronic pain can reclaim a higher quality of life.
About the Author
Dr. Gozani currently serves as Chairman of the board of directors and President and Chief Executive Officer of NeuroMetrix, Inc. NeuroMetrix is a commercial stage, innovation driven healthcare company combining bioelectrical and digital medicine to address chronic health conditions including chronic pain, sleep disorders, and diabetes. The company’s lead product is Quell, an over-the-counter wearable therapeutic device for chronic pain. The company is located in Waltham, Massachusetts and was founded as a spinoff from the Harvard-MIT Division of Health Sciences and Technology in 1996.