«Children often do not receive the appropriate diagnosis and treatment, among other things because there are no specific specialized programs for managing chronic pain in the child and youth population with the same characteristics and resources as those available for adults,» Miró denounced.
In addition, he pointed out that another cause of underdiagnosis is the «lack of training among healthcare professionals and the general population, who tend to think that children cannot suffer pain like adults or that pain affects them less.»
Miró expressed these views during his participation in the XXI National Congress of the Spanish Pain Society (SED), held in Malaga. Experts at the meeting have indicated that 4 out of 10 children, around 3.2 million, suffer from chronic pain, which affects their quality of life, a higher percentage than in adults (26%) and they claim that it is growing worldwide, but they are diagnosed and treated less than their older counterparts.
On the other hand, the president of the SED, María Madariaga, noted that the difficulty in diagnosing also influences «the challenge of objectifying it with an imaging test.» For this reason, an area of research that pain specialists are working on is to detect neurobiological markers that can help understand chronic pain.
THE RELATIONSHIP BETWEEN PAIN AND INFLAMMATION IN BRAIN TISSUES
In this regard, a pioneering research led by Dr. Marco Loggia, director of the Pain and Neuroinflammation Imaging Laboratory at the Massachusetts General Hospital in the United States, was presented at the congress, linking chronic pain with neuroinflammation.
«The most important implication of our work is the emerging evidence of the role of brain inflammation in patients with chronic pain. It remains to be determined if this approach can be used to objectively detect the presence of pain,» Dr. Loggia stated.
«Interestingly, we have observed that the neuroinflammatory signal appears to differ depending on the pain state, with different spatial distributions. This raises the possibility of identifying specific neuroinflammatory signatures for each condition that could aid in diagnosis and, potentially, in the adaptation of treatment strategies,» he added.
The implications are broad: «If successful, these tools can aid in diagnosis, especially in diseases traditionally diagnosed by exclusion, such as fibromyalgia. And more importantly, they can help validate the experiences of patients who are often not believed or stigmatized, by providing objective evidence of underlying biological changes,» Dr. Loggia emphasized.
Indeed, as Madariaga points out, «in addition to children, women often struggle to have their pain recognized in terms of diagnosis and medical leaves, especially in conditions where there are fewer objective tests, such as fibromyalgia and other conditions of nociceptive pain, widespread pain, chronic fatigue, hypersensitivity to stimuli, and cognitive impairments.»
On the other hand, this line of research, according to Marco Loggia, «could encourage pharmaceutical companies to explore treatments targeting neuroinflammation for pain, with entirely new drugs or by repurposing existing compounds that have already been shown to modulate brain inflammation in other diseases, such as multiple sclerosis,» he highlights.
In his opinion, «a future where clinical trials incorporate brain imaging as a preliminary step to help identify drug candidates with the highest likelihood of effectiveness and optimize dosing is possible.»