Abstract

Ankit Dhakad, Pragya Sharma, Dr. Rita Mourya, Dr. Shailesh Jain

ABSTRACT

This critical review examines pharmacological interventions for chronic pain management, synthesizing current evidence on efficacy, safety, and implementation strategies. Chronic pain affects approximately 1.5 billion people worldwide, representing a significant healthcare burden with profound impacts on quality of life and functioning. We analyze the pathophysiological mechanisms of nociceptive, neuropathic, and mixed pain types, highlighting their implications for treatment selection. Evidence supports a mechanism-based approach to pharmacotherapy, with non-opioid analgesics showing moderate effectiveness for nociceptive pain while anticonvulsants and antidepressants demonstrate superior efficacy for neuropathic conditions. Opioid analgesics provide significant short-term relief but have limited long-term efficacy and substantial safety concerns. Combination therapy targeting multiple pain mechanisms yields superior outcomes compared to monotherapy, supporting multimodal approaches. Patient-centered care incorporating comprehensive assessment, personalized medicine principles, and multidisciplinary integration optimizes treatment outcomes. Regulatory and ethical considerations significantly impact prescribing practices, necessitating a balanced approach to risk management and medication access. Future research priorities include comparative effectiveness studies, precision medicine approaches, and novel analgesic development to address current treatment limitations. This review provides clinicians with evidence-based recommendations for optimizing pharmacological management of chronic pain while identifying critical knowledge gaps requiring further investigation.