A glimpse into the future of pain treatment, where electricity, artificial intelligence, and personalized medicine are revolutionizing a field once dominated by opioids.
Imagine waking up every day feeling like your entire body is on fire. For Ed Mowery, a 55-year-old former guitarist, this was his reality. "Just imagine the worst burn you've ever had, all over your body, never going away," he described. "I would wake up in the middle of night, screaming at the top of my lungs." After approximately 30 major surgeries and 17 daily medications that provided little relief, Mowery represented one of medicine's most perplexing challenges: chronic pain that defies conventional treatment 6 .
It is for patients like Mowery that Dr. Dorene O'Hara wrote Heal the Pain, Comfort the Spirit: The Hows and Whys of Modern Pain Treatment. As an anesthesiologist with extensive training in pain management and clinical pharmacology, O'Hara explores the complex phenomenon of chronic pain that remains "poorly understood even in the medical centers devoted to its diagnosis and treatment" 1 . Her work acknowledges what statistics confirm: chronic pain is not merely a symptom but a devastating public health crisis affecting millions worldwide 1 3 .
This article examines the insights from O'Hara's foundational text alongside groundbreaking advancements that are reshaping our approach to pain, from revolutionary neuromodulation therapies to artificial intelligence-driven treatment protocols. As we'll explore, the future of pain management is evolving from simply masking symptoms to addressing the complex biopsychosocial factors that make each person's pain experience unique.
Chronic pain represents one of modern medicine's most significant challenges, both in its scale and complexity. Specialists estimate that as many as 60 million Americans suffer from chronic pain, with approximately 20% of populations in developed countries reporting persistent pain issues 1 . The economic impact is staggering—one study estimates the financial cost of pain in the U.S. totals between $560-635 billion annually in medical expenses and lost productivity 3 .
Americans with Chronic Pain
Adult Population Affected
Chronic Back Pain Sufferers
Annual Economic Impact
What makes chronic pain particularly challenging is its resistance to simple solutions. As O'Hara explains through case studies and clinical experience, pain exists within a person, necessitating healing that comes from within 9 . This perspective marks a significant departure from traditional biomedical models that focused primarily on pharmacological interventions, often with limited long-term success and significant risk of dependency.
The history of pain management reveals a field in constant evolution. Early civilizations used natural substances like coca leaves containing cocaine for pain relief dating back over 3000 years 3 . The 20th century saw the introduction of NSAIDs and, later, the aggressive marketing of opioids for chronic pain—a approach that would ultimately contribute to the opioid epidemic 3 .
Natural substances like coca leaves, willow bark, and opium used for pain relief 3 .
Isolation of active compounds: morphine from opium, aspirin from willow bark.
Development of NSAIDs and synthetic opioids; aggressive marketing of opioids for chronic pain leads to addiction crisis 3 .
Recognition of biopsychosocial model; multidisciplinary pain clinics emerge.
Neuromodulation, regenerative medicine, and personalized approaches transform the field.
The limitations of these traditional approaches became increasingly apparent. As research advanced, it became clear that opioids are not suited for chronic pain as a first-line treatment in most cases, with utility primarily in cancer-related pain and palliative care 3 . Meanwhile, NSAIDs, while less addictive, carry risks of gastrointestinal damage and cardiovascular problems while often proving inadequate for severe pain 3 .
This recognition has sparked what O'Hara calls for in her book: a more comprehensive treatment approach that acknowledges the "inseverable relationship between pain's physical and mental aspects" 9 . This biopsychosocial model forms the foundation of modern pain management, considering not just the physical sensation of pain but also the psychological, social, and even spiritual dimensions of the pain experience.
At the heart of O'Hara's work is the principle that effective pain management requires a trusting relationship between patient and physician—one that takes time to develop and stands in direct contrast to managed-care organizations that emphasize cutting costs by shortening physician time with each patient 9 .
One of the most important concepts in modern pain neuroscience is central sensitization—a condition where the nervous system enters a state of heightened sensitivity, essentially amplifying pain signals 4 .
O'Hara emphasizes the importance of integrating various therapeutic modalities, examining "the important contributions made by other clinical professionals and by practitioners of alternative medicine" 1 .
The International Association for the Study of Pain (IASP) has developed toolkits specifically focused on creating Multidisciplinary Pain Centers that can serve as "hubs" and centers of excellence 5 .
"Pain relief is a basic human right." - Dorene O'Hara, Heal the Pain, Comfort the Spirit 9
While O'Hara's book provides a foundation for understanding chronic pain, recent technological advances have opened possibilities that were barely imaginable when her text was published. One of the most promising areas involves personalized neuromodulation—the use of electrical impulses to precisely alter nerve activity.
A groundbreaking clinical trial published in 2025 demonstrates the potential of this approach. The study involved patients with devastating cases of chronic pain that had failed to respond to conventional treatments, including spinal cord stimulators and high-dose opioid regimens 6 .
Use electrical impulses to alter nerve activity with increased precision and remote monitoring capabilities 2 .
In Clinical UseAnalyze imaging studies and patient data to pinpoint exact pain sources and recommend individualized treatment strategies 2 .
EmergingLiposomal formulations and quantum dot nanoparticles for targeted drug delivery and biomarker quantification 3 .
ExperimentalAs we look toward the horizon of pain management, several key trends emerge that build upon the foundation laid by O'Hara while incorporating recent technological advances:
The integration of AI into pain management represents one of the most significant shifts, with potential to enhance diagnostic accuracy and support personalized care 2 .
Pharmacogenetics enables truly personalized medication plans by analyzing how genetic variations affect drug effectiveness and tolerance 3 .
"It's highly innovative work, using the experience and technology they have developed and applying it to an underserved area of medicine." - Dr. Andre Machado, on deep brain stimulation research 6
In Heal the Pain, Comfort the Spirit, Dorene O'Hara reminds us that "pain relief is a basic human right" 9 . This powerful statement encapsulates the moral imperative driving innovation in pain management. As research continues to reveal the complex mechanisms underlying chronic pain, the field is moving toward approaches that acknowledge both the physiological and psychological dimensions of suffering.
The promising developments in neuromodulation, regenerative medicine, artificial intelligence, and personalized treatment all point toward a future where chronic pain may be more effectively managed—or perhaps even prevented. Yet these technological advances must be integrated with the fundamental principles O'Hara advocates: a trusting patient-physician relationship, a comprehensive approach that addresses the whole person, and recognition that healing must come from within the individual 9 .
For the millions living with chronic pain, these innovations offer something precious: hope. Hope that future patients may not have to endure decades of suffering like Ed Mowery. Hope that pain management can evolve from simply suppressing symptoms to actually facilitating healing. And hope that by combining cutting-edge science with compassionate care, we can truly learn to both heal the pain and comfort the spirit.