Emerging therapeutic strategies for chronic pain

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Abstract
Chronic pain affects a high percentage of the general population. Traditional therapies based upon non-steroidal anti-inflammatory drugs (NSAIDs), opioids and co-analgesic therapies, such as antidepressant or anti-epileptic drugs, are often relatively ineffective in treating chronic pain. In addition, the low therapeutic indexes and, in particular, the often-intolerable side effect profiles of conventional compounds, limit their usefulness, especially in the elderly population. Despite intensive research, until recently there was little change in the classes of drugs available to treat chronic pain clinically. This was partly due to a failure to understand which physiological processes are important in mediating clinical chronic pain. Recently, however, greater understanding of the neurophysiology critical to chronic pain development has lead to the development of numerous alternative pharmacological strategies. This review article outlines the physiological processes occurring in chronic pain, highlights...