Prevention of Chronic Pain

The Transition to Chronic Pain

Ethismos seeks to Prevent the Development of Chronic Pain by Preventing the Acute to Chronic Pain Transition.

Persistent Post-Surgical Pain (PPSP) is the prototypical acute to chronic transition. PPSP is a major post-operative complication (approximately 40% of the 37 million major surgeries per year in the US (approximately 350 million surgeries/year worldwide). Trauma, wartime injury, or sports injury are also situations where this chronic neuropathic pain can persist, even after the initial injury heals. One-year longitudinal imaging studies in patients with low back pain with characteristic mood and corresponding anatomic and functional brain changes predict development of chronic pain one year later.

Pre-operative pain, anxiety, depression, and pain catastrophizing* are among the strongest predictors for PPSP. Severe post-operative pain is another known predictor of PPSP.

No drugs are approved for PPSP. Ketamine, anticonvulsants, and antidepressants have not shown consistent benefit. Opioids do not prevent PPSP and are less helpful because of risk of addiction and significant long-term side effects.

The Ethismos team of scientists - along with our collaborators - are determined to develop safe and effective regimens to block the development of chronic pain.

*pain catastrophizing is a negative cognitive state related to the belief that the experienced pain will inevitably result in the worst possible outcome