A new study by McGill University researchers shows that chronic pain, often invisible to medical tests, can be better assessed when doctors take a holistic approach.
By combining biological data with information about patients' mental health, sleep and stress, the researchers say they were able to create a fuller picture of chronic pain. They said their findings, published in Nature Human Behaviour, stand to improve how the condition is diagnosed and treated.
Chronic pain affects one in five adults, yet because it often doesn't appear on blood tests or scans, many people are dismissed or left without answers.
"Biological data tells us what's wrong, but not how something feels," said lead author Etienne Vachon-Presseau, a member of McGill's Alan Edwards Centre for Research on Pain and an associate professor in the Faculty of Dental Medicine and Oral Health Sciences.
"Sleep problems, stress and mood can all influence how the brain processes pain, shaping how severe it feels and how much it interferes with daily life," he said.
The team used machine learning to analyze data from more than 500,000 people in the United Kingdom. Their models could accurately identify medical conditions linked to chronic pain, such as arthritis or gout. However, they could not predict how much pain a person reported feeling. When mental health, sleep and stress data were added, the models' performance improved significantly, capturing both a person's physical condition and experience of pain.
The novel approach could help doctors choose treatments that target the source of pain and address the psychological and emotional struggles that may be making it worse. The authors say their findings also help validate the experiences of patients living with a condition that is notoriously difficult to diagnose.
"Our research shows that pain can be detected and understood when we look at the whole person," said Vachon-Presseau. "Patients, health-care providers and policymakers will benefit by adopting a more holistic approach to assessing chronic pain."
About the study
"Biological markers and psychosocial factors predict chronic pain conditions" by Matt Fillingim and Etienne Vachon-Presseau et al., was published in Nature Human Behaviour.
The study was funded by the Canadian Institutes of Health Research, Fonds de recherche du Québec - Santé and the Louise and Alan Edwards Foundation.
