Pain epistemology and treatment approaches

Aim: To investigate the epistemology of chronic pain, the methodology of approaches to its treatment, and to highlight the economic and social aspects related to the issue of chronic pain. Materials and Methods: A comprehensive literature search was conducted using the following databases: Google Scholar, PubMed, Scopus, Web of Science, and SpringerLink. The search included combinations of the following key words: chronic pain, causes of pain, biopsychosocial model of pain, multimodal pain management, economics of chronic pain. The search covered publications from 1994 to 2025. Studies were selected based on the following inclusion criteria: peer-reviewed articles, meta-analyses, systematic reviews. The following were excluded from the search: conference abstracts, editorials, commentaries. The initial search yielded over 90 publications. After checking for relevance, 34 articles were included in the final review. Conclusions: Pain is dualistic, both in origin and in its mechanisms of implementation. It is simultaneously a physical sensation and an emotional reaction, encompassing cognitive and social components. Convincing evidence has been obtained regarding the presence of functional, structural, and chemical changes in the brain that occur due to continued pain. Chronic pain is a complex biopsychosocial concept. Therefore, the development of a biopsychosocial model of pain is needed, both along the lines of patient–society and patient–medicine, as well as incorporating feedback. Only targeted multimodal medical care, together with a transformation in the sociocultural perceptions of patients with chronic pain, allows improvement in treatment outcomes, economic efficienc and social adaptation of affected individuals. This requires an appropriate multidisciplinary approach and wide implementation of innovative methods and techniques of medical care for patients with pain syndromes, taking into account the biopsychosocial model of pain.