Chronic pain costs the U.S. economy hundreds of billions of dollars a year. The economic burden created by direct medical care costs and lost productivity from pain is larger than the burden created by cancer, diabetes, and cardiovascular disease combined, according to the National Institutes of Health. It also fuels the nation's devastating opioid epidemic.
But what if you could stop pain before it starts? That is the ultimate goal of a group of scientists from five U.S. research institutions who are working with the Restoring Joint Health and Function to Reduce Pain (RE-JOIN) Consortium.
Armen Akopian, PhD, is one of those scientists. He's a professor in the Department of Endodontics at the School of Dentistry at The University of Texas at San Antonio. He's working on mapping the nerves that are involved in pain in the temporomandibular joints (TMJ), the joints of the jaw, and the muscles around them. Pain in this area can significantly reduce a person's quality of life.
"We chew, we speak, now I'm talking to you. It's involved with every second," Akopian said. When people experience pain in that area, "That's a devastating effect," he said.
Another type of chronic pain, musculoskeletal pain, is a leading cause of disability in the United States, experienced by more than half of the population. "If we take a joint pain, back pain, exercise-dependent pain, it's now absolutely number one," Akopian said.
People don't die from pain; they live with it, Akopian explained. That can cause their lives to shrink. He describes this as living half a life: "Can't climb the stairs, can't travel with you. Are you going hiking? I can't hike anymore. You're doing this, I can't do that anymore." If he and his colleagues discover how to target the biological mechanisms that cause and sustain pain, it could give those people their lives back. "That will make life more productive, and we probably will not be able to put a value on that," he said. "How much can we value a normal life compared to half a life?"
The prevalence of pain in the U.S. population is part of the reason the number of people with opioid use disorders has exploded since doctors began prescribing that class of medication for pain management in the 1990s, Akopian said. "70% of addicted people had pain. They had no choice. They needed to suppress that pain. They end up in addiction, and when the pain is gone, the addiction remains."
The RE-JOIN consortium was assembled as part of a federal effort to "speed scientific solutions to stem the national opioid public health crisis," according to the National Institutes of Health. The ultimate goal is to build a foundation on which scientists can develop the first targeted, non-opioid treatment for chronic pain associated with muscle and joint dysfunction.
And for people who experience excruciating pain associated with life-saving medical treatments like chemotherapy, Akopian says there is no medication at all that works to help them manage it. "Existing treatments, they're all ineffective, literally no exceptions," he explained. Right now, the only alternative for some of these patients is to reduce their chemotherapy dose, but Akopian explained that's not a great option. "If they reduce the dosage, they will compromise the survival of the patient."
"So in these conditions, you need to prevent pain," Akopian said.
RE-JOIN is a five-year, $9 million project. It was recently assessed at the three-year mark and given the approval to continue its research. "For UT San Antonio, this grant elevates our national visibility and validates the Center for Pain Therapeutics and Addiction Research we have built," Akopian concluded.
RE-JOIN is a five-year, $9 million project. It was recently assessed at the three-year mark and given the go-ahead to continue its research. "For UT San Antonio, this grant elevates our national visibility and validates the Center for Pain Therapeutics and Addiction Research we have built,” Akopian concluded.
Science & Medicine is a collaboration between TPR and The University of Texas Health Science Center at San Antonio, about how scientific discovery in San Antonio advances the way medicine is practiced everywhere.
