Episode 210: An overview of Pain with Steve Cohen

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, requiring a biopsychosocial model to fully understand its impact on patients. Dr. Steven Cohen, Chief of Pain Medicine at Johns Hopkins, emphasizes that pain classification—categorized mechanistically into nociceptive, neuropathic, and nociplastic types—is essential for determining effective treatment. While nociceptive pain often responds to conventional interventions, nociplastic conditions like fibromyalgia lack clear biomarkers and require multidisciplinary approaches, including exercise and sleep management, rather than surgery or opioids. Chronic pain transition is multifactorial, involving genetic, psychological, and social variables that necessitate personalized, mechanism-based care. Future advancements in pain management will likely shift toward precision medicine, utilizing targeted biological therapies and addressing the affective-motivational components of pain to improve long-term patient outcomes beyond simple symptom suppression.