If you live with chronic pain, you have probably noticed something frustrating about your treatment options. There are not that many, and most of them were not designed for your condition in the first place. Here is a fact that surprises most people: there is no drug approved by the FDA for chronic pain as a whole. Every approval is tied to a specific condition, and until January 2025 the field had not seen a genuinely new class of pain medicine in over 20 years. This article walks through what is actually approved today, what researchers are testing right now, and why pain research moves slower than almost any other field. And why that is finally starting to change.
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What's approved for chronic pain today
Here's the honest answer: there's no drug approved for "chronic pain" as one single condition. Instead, the FDA approves pain medications for specific diagnoses, so what your doctor can prescribe depends on what's actually causing your pain.
Duloxetine is approved for chronic muscle and joint pain, diabetic nerve pain, and fibromyalgia. It was originally made as an antidepressant, but it also works on brain chemicals that control how pain signals get turned up or down.
Pregabalin is approved for diabetic nerve pain and fibromyalgia. It calms down overactive nerve signals.
Milnacipran is approved for fibromyalgia and works in a similar way to duloxetine.
Capsaicin 8% patch is approved for diabetic nerve pain in the feet. It uses the same compound that makes chili peppers spicy to calm overactive nerve pain in the skin.
Extended-release opioids are still approved, but only for severe chronic pain that hasn't responded to anything else. After the opioid crisis, doctors and regulators now treat them as a last resort, not a first option.
And then there's the new one. In January 2025, the FDA approved Journavx (suzetrigine), the first drug in a brand-new class called NaV1.8 pain blockers. It works by blocking a specific pathway that pain nerves use to send signals to the brain, and importantly, it's not an opioid. Here's the catch: it's only approved for short-term, moderate to severe pain, like what you'd feel after surgery or an injury. Not for chronic pain. That gap between what's approved and what patients actually need is exactly where clinical trials come in.
What researchers are studying now
The biggest question in pain research right now: can the new non-opioid medicines that work for short-term pain also work for chronic pain?
Where does Journavx stand for chronic pain?
Vertex, the company behind Journavx, is actively testing exactly that. Their main focus is painful diabetic peripheral neuropathy, a common type of chronic nerve pain. Two large trials are currently recruiting, one aiming for about 1,100 people, the other for just over 700, and as of a January 2026 update, the company expects to finish enrolling both by the end of 2026. There are no results yet. Until there are, nobody can honestly say whether this drug actually helps with chronic pain, that's the whole point of running these studies.
An earlier, smaller study gives a sense of how hard this is to prove. It tested the drug in people with a specific type of nerve pain that runs from the lower back down the leg. After 12 weeks, people taking the drug felt noticeably better, but so did the people taking a placebo (a fake treatment), by almost the exact same amount. So even though people on the real drug genuinely felt better, the study couldn't prove the drug worked better than nothing. Interestingly, Vertex found that at about 4 in 10 of the study locations, where fewer people responded to the placebo, the drug clearly did outperform it. Based on that, the company decided to move forward into a larger trial anyway.
Most chronic pain studies aren't testing drugs at all
Here's something that surprises most people: the majority of chronic pain research happening right now has nothing to do with drugs. Only about 1 in 7 chronic pain studies recruiting worldwide is actually testing a medication. The rest are studying devices, behavioral programs, mind-body techniques, or simply trying to understand how chronic pain works in the first place. As of August 2026, there are over 900 chronic pain studies recruiting worldwide, 365 of them in the US. Big names are behind many of them, the VA, Stanford, Massachusetts General Hospital, UCLA, and Johns Hopkins, alongside companies like Eli Lilly and Boston Scientific. These aren't small pilot studies either: the Healing Track trial at Mount Sinai's Icahn School of Medicine is currently recruiting 180 people with chronic back pain.
Some studies are specifically designed for people research has historically overlooked. The Minneapolis VA Medical Center is recruiting 500 rural veterans for a mind-body wellness program delivered remotely. A smaller study at UC San Diego is testing a pain management approach designed specifically for Indigenous communities, with 30 participants.
Why chronic pain research takes time
The placebo problem. Pain trials measure success by simply asking people how much they hurt, usually on a scale of 0 to 10. Surprisingly, a lot of people actually do feel better after taking a placebo (a fake treatment with no active medicine). The suzetrigine study mentioned above is a perfect example: people got almost identical pain relief whether they took the real drug or the placebo. When a placebo works that well, a real drug has to clear a really high bar to prove it's actually doing something, which means promising treatments can fail a trial without actually being useless.
The measurement problem. There's no blood test or scan that can measure pain directly. Everything relies on people describing how they feel, and that varies a lot, from person to person, and even from one study location to another. Researchers have noticed that how much people respond to placebo can differ sharply between sites, which makes it harder to tell if a drug is truly working. Some teams are trying to solve this at the source: Northwestern University is running a government-funded study testing a wearable "smart band-aid" that tries to actually measure chronic pain in women, instead of just asking them to describe it.
The umbrella problem. Chronic pain isn't one single disease. Arthritis pain, nerve pain, and fibromyalgia all work differently in the body, so each drug has to be tested separately for each condition. That's exactly why there's no single "chronic pain" approval, and why this field needs so many individual trials.
Does chronic pain affect more than pain?
Research says yes. A large US study that followed adults over time found that people with chronic pain had higher rates of depression, anxiety, sleep problems, obesity, physical inactivity, and smoking. The same study found roughly twice the risk of death over the follow up period compared with pain free adults, and about two and a half times for people whose pain limited daily life. Most of that extra risk traced back to conditions like heart disease and to lifestyle factors, and it shrank, though did not disappear, once researchers adjusted for those.
The mental health side now has hard numbers behind it. In March 2025, a team led by Johns Hopkins Medicine published an analysis of the question in JAMA Network Open that pooled 376 studies covering 347,468 adults with chronic pain across 50 countries. Roughly 4 in 10 of those adults had clinical symptoms of depression, and a similar share had clinical symptoms of anxiety. The risk was highest for women, for younger adults, and for people living with fibromyalgia.
These are population level numbers, not a forecast for you. But they are a good reason to treat chronic pain as a whole body condition. If your pain comes with poor sleep, low mood, or less activity, bring all of it to your doctor, not just the pain score.
Common myths about chronic pain
"It's all in your head."
Not true. There's a real, recognized type of chronic pain called nociplastic pain, where the nervous system itself amplifies pain signals. Scans and tests can come back completely normal even though the pain is real and physical. Fibromyalgia is the best-known example, and this type of pain is officially recognized in the international medical classification system (ICD-11).
"Opioids are the only real treatment."
Not true, and the field is actively moving away from them. Most approved chronic pain medications aren't opioids at all, and the newest class of pain drug (NaV1.8 inhibitors) was specifically developed as a non-opioid option after the opioid crisis changed how doctors approach pain treatment.
"Chronic pain is just part of getting older."
It does become more common with age. More than 1 in 3 US adults over 65 have it, compared to about 1 in 8 younger adults. But "common" doesn't mean "untreatable," and a lot of current research is focused specifically on older adults.
The three types of chronic pain, and what care usually looks like
Chronic pain doesn't have a staging system the way some diseases do. Instead, doctors classify it by how it happens in the body, and clinical trials tend to recruit along those same lines.
Nociceptive pain happens when the body is reporting real, ongoing damage in the tissue, osteoarthritis is the classic example. Care usually combines physical therapy, anti-inflammatory medication, changes to activity, and sometimes injections or surgery to treat the underlying issue.
Neuropathic pain starts when the nerves themselves have been damaged, like in diabetic nerve damage or the lingering pain some people get after shingles. Care usually relies on nerve-targeting medications like duloxetine, pregabalin, or the capsaicin patch, since regular painkillers often don't do much for this type of pain.
Nociplastic pain works differently: the nervous system itself turns up pain signals, even without any ongoing injury to find. Fibromyalgia is a good example of this. Care usually combines approved medications with sleep treatment, gradual exercise, and psychological approaches that help retrain how the nervous system processes pain.
These are just descriptions of what typical care looks like, not a specific recommendation. Your own treatment plan is something to work out with your doctor.
There's also a newer, more official way doctors classify chronic pain. The international disease classification (ICD-11) now separates chronic primary pain, where the pain itself is considered the disease, from six categories of chronic secondary pain, where the pain is caused by another condition. Chronic primary pain includes things like fibromyalgia and lower back pain with no clear cause. And the term many patients still use, "chronic pain syndrome," doesn't actually appear anywhere in this official classification. When doctors use that term, they usually mean something close to chronic primary pain: long-lasting pain that causes real distress or disability and isn't explained by anything else. Either way, for clinical trials, it works out the same: studies recruit around a specific diagnosis or type of pain, not "chronic pain" in general.
What about chronic back pain?
Back pain deserves its reputation. In 2020, 619 million people worldwide were living with low back pain, and the WHO expects that number to grow to 843 million by 2050 as populations get older. No other condition causes more disability globally. Those numbers include every kind of back pain episode, including short ones, and most short-term back pain actually gets better on its own. But when it doesn't, and the pain lasts longer than three months, it's considered chronic back pain, part of the same broader category this article is about. Women tend to carry more of this burden than men, and the risk grows with age up until around 80. It's no surprise research interest matches the size of the problem: the Healing Track trial mentioned earlier is built specifically around chronic back pain.
How to find a chronic pain study
On AllClinicalTrials.com you can browse chronic pain studies recruiting near you, filter by location, and apply in about 5 minutes. A couple of examples show the range of what's currently recruiting: Weill Cornell Medicine is running a study on integrated PTSD and chronic pain treatment, since the two conditions often show up together, and the University of Alabama at Birmingham is testing an opioid tapering program for people preparing for hip or knee replacement surgery.
Common questions
What is chronic pain, in simple terms? Chronic pain means pain that lasts three months or longer, whether it's constant or comes and goes. Often the original injury healed a long time ago, but the nervous system stays "switched on" and keeps sending pain signals anyway. Doctors now treat this as its own medical condition, not just a symptom pointing to something else.
What scale do pain trials use to measure results? Most use something called the Numeric Pain Rating Scale (NPRS), where you rate your pain from 0 to 10. Some studies also use the Brief Pain Inventory, which asks how much pain gets in the way of your daily activities.
Is Journavx approved for chronic pain? No. Journavx (suzetrigine) is currently only approved for moderate to severe short-term (acute) pain. Studies testing whether it also works for chronic pain conditions, including diabetic nerve pain, are still ongoing.
How common is chronic back pain? Very common. Low back pain affected about 619 million people worldwide in 2020, and the WHO expects that number to reach 843 million by 2050. The WHO actually calls low back pain the single leading cause of disability in the world. Those numbers include all kinds of back pain, not just the long-lasting type, most short-term episodes get better on their own. But for some people, the pain sticks around and becomes chronic. It affects women more often than men, and it becomes more common with age, up until around age 80.
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