ALL PAIN, NO GAIN

SCIENCE HAD ITS ‘CHRONIC PAIN REVOLUTION.’ SO WHY IS TREATMENT STILL BROKEN, DELAYED AND OUT OF REACH?

- by Alexis Kayser

DR. ADRIAAN LOUW HAS HEARD the term “pain revolution” before. The physical therapist and scientist has been researching chronic pain for more than 30 years. Over the decades, he has witnessed the rise of opioid prescriptions—and seen them replaced by other prescription medications and invasive medical procedures. He has watched patients be dismissed as malingerers as doctors struggle to ease their debilitating symptoms.

For awhile, it seemed to Louw and his small group of colleagues that no one really understood chronic pain. Patients were still hurting. The treatments they fought hard for didn’t always work. “When I came into the profession, people told me, ‘Oh, there’s a pain revolution, there’s a pain revolution!’” Louw told Newsweek. “I kept looking around, like, ‘Where is it?”

But now, in 2025, Louw agrees with the diagnosis. There has indeed been a pain revolution, he said: a “huge” one. The science is advancing, and the mechanisms behind chronic pain are no longer a mystery.

So why is the problem getting worse? Newsweek interviewed more than a dozen of the nation’s leading chronic pain specialists and researchers, asking why the number of chronic pain patients is rising if the science is truly accelerating.

Their consensus: We have the knowledge to treat chronic pain and even, in some cases, to cure it. But the U.S. health care system is not set up for the sort of treatments that patients need and our fee-for-service payment structure does not incentivize change.

As Louw put it, “We still have a lot of yuckiness in the medical world.”

In 2023, nearly one in four adults struggled with chronic pain, or pain that persists for more than three months. That's a 4 percent increase from 2019, according to the most recent data from the Centers for Disease Control and Prevention.