By: Joel Michael Reynolds
The American Academy of Pain Medicine reports that pain affects 100 million people, “more Americans than diabetes, heart disease and cancer combined…A recent market research report indicates that more than 1.5 billion people worldwide suffer from chronic pain” in particular. But if all we need to stop chronic pain is a simple ‘off switch,’ why have over 40 years of pain research, the creation of thousands of pain research centers across the world, and the medical establishment of pain specialists failed in finding it? The short answer is that pain is not like a light bulb. There is no simple “off switch.” It is less a current or flame, and more a force.
Typical, acute pain (like holding one’s hand over a fire) occurs from anticipated or actual nerve damage. Quick acting A-δ nerve fibers lead an organism to move itself away from the localized cause of pain, while the restorative system enlists the slower C fibers to kick in long after the acute occurrence and thus lead one to immobilize the area in order to heal. In cases related to acute pain, clinicians can focus not simply on symptoms, but also on their underlying causes like tissue damage. Yet many chronic pain syndromes, such as CRPS/RSD (Complex Regional Pain Syndrome Type 1, formerly Reflex Sympathetic Dystrophy), seem to occur without nerve or tissue damage. This complexity adds to the puzzling fact that whereas the ability to experience pain is a crucial adaptational tool for human and many non-human organisms, chronic pain is maladaptive. The search for easy fixes to pain relief is old, but science is still in its infancy with respect to understanding pain, especially of the chronic sort.
As beneficial as the study on A3AR may be, it still relies on a simplistic, symptomatic approach. It does not address the cause of chronic pain. While there is substantial and ongoing research into a variety of symptomatic approaches, from tamper-proof, high-power opioids to spinal simulators, the holy grail of pain research is to understand the cause of chronic pain and develop methods to treat it. Yet, the complexity of chronic pain as a research topic and as a lived experience is lost amidst reports on the sheer number of people with chronic pain or, worse, reports that myopically focus on opioid-abuse, a framing that still lingers from the failed and continually failing Nixon-era war on drugs. The reduction of pain policy to drug policy  works in tandem with the unending production of articles about how to reduce, control, or eliminate pain in medical news and media. Pain becomes a problem to be solved by adding or removing some factor. Pop a pill here, outlaw a pill there. Activate a receptor here, deactivate a receptor there. But these approaches reveal a failure to comprehend the phenomenon of pain. Pain, like gravity, is a force. We can measure it, feel it, alter it, study it, and even exploit it, but we still don’t really know how it works. Especially for those whose lives become defined by it, hopefully we someday will.
 On the history of pain medicine and pain research, see Isabelle Baszanger, Inventing Pain Medicine: From The Laboratory To The Clinic (New Brunswick, N.J.: Rutgers University Press, 1998).
 For a general explanations of this, see Patrick D. Wall, Pain: The Science Of Suffering, Maps of the Mind (New York: Columbia University Press, 2000), 40-43. For a more philosophically oriented explanation, see Nikola Grahek, Feeling Pain And Being In Pain, Pbk. ed. (Cambridge, Mass.: MIT Press, 2007), 141-66.
 E.g., see Kenneth D. Craig’s article, “Emotions and Psychobiology” in Patrick D. Wall et al., Wall And Melzack's Textbook Of Pain, 5th ed. (Philadelphia: Elsevier/Churchill Livingstone, 2006), 232-33.
 Anne Werner and Kirsti Malterud, "It Is Hard Work Behaving As A Credible Patient: Encounters Between Women With Chronic Pain And Their Doctors," Social Science & Medicine 57, no. 8 (2003). Melissa A. Day and Beverly E. Thorn, "The Relationship Of Demographic and Psychosocial Variables To Pain-Related Outcomes In A Rural Chronic Pain Population," PAIN 151, no. 2 (2010). Mary-Jo DelVecchio Good, Pain As Human Experience: An Anthropological Perspective, Comparative Studies Of Health Systems And Medical Care (Berkeley: University of California Press, 1992); Gillian Bendelow, "Pain Perceptions, Emotions And Gender," Sociology of Health & Illness 15, no. 3 (1993); Raymond C. Tait and John T. Chibnall, "Racial/Ethnic Disparities In The Assessment And Treatment Of Pain: Psychosocial Perspectives," American Psychologist 69, no. 2 (2014).
 See Corey Goergen’s piece on this topic here on Destination Health EU, “Accidental Addicts and Junkies: Class and Sanjay Gupta’s “Prescription Drug Death Epidemic,” October 6th, 2014, http://www.destinationhealtheu.org/news-perspectives/accidental-addicts-and-junkies-class-and-sanjay-guptas-prescription-drug-death-epidemic.
 Daniel S. Goldberg, The Bioethics Of Pain Management: Beyond Opioids, Routledge Annals of Bioethics (New York: Routledge, Taylor & Francis Group, 2014).