This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Pain, when it is pathological and therefore especially chronic, represents a huge health problem all over the world. The numbers tell us that the prevalence of chronic pain is 33.5%, or 105 million people, with a cost of more than 100 billion dollars a year. We can classify pain into acute (high intensity and short duration) and chronic (low intensity and long duration). Examples of acute pain include pain as a result of an injury or acute post-surgical pain. Chronic pain can be further divided into nociceptive, neuropathic, visceral, and mixed pains. Neuropathic pain, in turn, can be divided into central and peripheral. Some examples make us understand the spread of the chronic pain phenomenon: Osteoarthritis is a nociceptive pain that affects about 16 million people; migraine and diabetic neuropathy, central and peripheral neuropathic pain, respectively, affect 31 million people and 3.2 million people, respectively; An example of visceral pain is that of pancreatitis, and finally, an extremely common mixed pain is that of the lower back, which affects 55 million people. A number of medications are used to treat chronic pain, and there are many new therapeutic strategies that are being developed. These include new formulations of old drugs, new indications of old drugs, and drugs with new mechanisms of action. A good alternative to allopathic medications are herbal or plant-derived medications. We have already published the first volume on herbal medicines useful for the treatment of pain (
Many drugs are currently available for the treatment of pain, including several categories of pharmaceuticals (acetaminophen, nonsteroidal anti-inflammatory drugs, antidepressants, antiepileptics, local anesthetics, and opioids). However, despite this large battery of drugs, their use is limited by the fact that one in four patients does not respond to therapies and by the numerous adverse effects such as, for example, poor tolerability, side effects, concern for long-term safety, potential for abuse, and discomfort with use. In addition, the utilization of analgesic drugs will continue to increase due to several factors, including an aging population, an increased prevalence of chronic pain conditions, newly approved products, and better education of doctors and patients about the possibility of treating pain (
Neuropathic pain is certainly the one that poses the greatest therapeutic problems. Chronic neuropathic pain conditions including idiopathic trigeminal neuropathic pain, post-herpetic neuralgia, central post-stroke pain, and complex regional pain syndrome. The medications that are currently most frequently used in these conditions are anti-convulsant medications such as pregabalin and antidepressant medications such as fluoxetine. Other drugs have been approved, some of which are plant-derived. For example, St John’s Wort, Ginger, Turmeric, Omega-3 Fatty Acids, Capsaicin, Thunder God Vine, Butterbur, Feverfew, and Willow Bark. However, there is an urgent need for other drugs to resolve conditions resistant to current drugs (
Neuropathic pain is addressed as a side effect caused by the cancer drug vincristine, the drug of choice for Hodgkin’s lymphoma, lymphoblastic leukemia, and non-Hodgkin’s lymphoma. Vincristine causes dose-dependent neuropathic pain. In an experimental mouse model,
Inflammatory pain also needs new and safer weapons. Sometimes, the pain becomes chronic if the inflammation is not promptly resolved. In addition, it can persist even after the damage that caused the inflammation has been cured (
The other three articles deal with inflammatory pain. The herbal formulation called Xue-Fu-Zhu-Yu-Tang (XFZYT) is derived from traditional Chinese medicine.
In conclusion, medicinal herbs may represent an alternative or may have an adjuvant role in current therapy. However, in many cases, clinical trials are needed to validate the encouraging results obtained preclinically.
DD: Investigation, Project administration, Validation, Visualization, Writing–original draft. W-LH: Conceptualization, Investigation, Project administration, Supervision, Validation, Visualization, Writing–review and editing. YH: Investigation, Writing–review and editing. M-YT: Validation, Writing–review and editing. H-RY: Visualization, Writing–review and editing.
The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
We thank all the authors of the articles collected in this Research Topic. We also thank all the reviewers who have provided the authors with very useful suggestions. Finally, we would also like to thank all the staff of the Editorial Offices of Frontiers for the great help offered in handling this Research Topic.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.