MICROBIOTA

microbiotakapak

CHRONIC PAIN AND MICROBIOTA

Gözde Erol1
Ufuk Turan2
Muhammet Tugay3
Ömer Taylan Akkaya4

1Ankara Etlik City Hospital, Department of Algology, Ankara, Türkiye
2Ankara Etlik City Hospital, Department of Algology, Ankara, Türkiye
3Ankara Etlik City Hospital, Department of Algology, Ankara, Türkiye
4Ankara Etlik City Hospital, Department of Algology, Ankara, Türkiye

Erol G, Turan U, Tugay M, Akkaya ÖT. Chronic Pain and Microbiota Within Us. Melek İM, Aydoğan S, eds. Microbiota. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.125-133.

ABSTRACT

Chronic pain is a prevalent medical condition affecting over 20% of adults and 6% of children, posing a substantial public health challenge with significant socioeconomic costs and profoundly diminishing patients’ quality of life. The pathophysiology of chronic pain involves a complex interplay of cellular, sensory, affective, and psychosocial processes. Although not fully elucidated, the gut microbiota has emerged as a potential mediator in the development of chronic pain. The gut microbiota-brain axis functions bidirectionally and plays a crucial role in maintaining homeostasis. The human gut hosts a dynamic population of trillions of microorganisms, representing over 1000 species. These microorganisms are essential in various physiological processes, including immune system regulation, pathogen recognition (via Toll-like receptors), and maintaining the integrity of the intestinal barrier (via short-chain fatty acids). The gut microbiota-brain axis has garnered significant interest, with numerous studies linking microbiota modulation to improvements in acute postoperative pain, visceral pain from irritable bowel syndrome, inflammatory pain in osteoarthritis, chronic neuropathic pain, chronic pelvic pain, and migraine pain. Probiotics and short-chain fatty acids, while not conclusively proven, are thought to influence gut microbiota through shared mechanisms and have been explored for the treatment and prevention of certain microbiota-related disorders. Microbiota dysbiosis may influence pain perception by affecting inflammation and immune system function through various chemical and receptor-mediated pathways. Microbiota-based treatments for chronic pain are promising, they are still in the early stages. In the coming years, both preclinical and clinical research will need to adopt more individualized approaches to effectively harness microbiota modifications for pain management.

Keywords: Chronic pain; Pain management; Dysbiosis; Gastrointestinal microbiome; Probiotics

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