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Pain affects 1 in 5 Americans, and experts say treating it effectively means going beyond the physical. At a recent rheumatology conference, Johns Hopkins' Dr. Traci Speed made the case for a multidisciplinary approach to chronic pain — one that includes antidepressants and psychiatric referrals when needed. Because pain and depression are deeply intertwined, treating one can meaningfully help the other.
Chronic pain isn't just a physical problem — and treating it like one is a missed opportunity. That was the message from Dr. Traci Speed, director of the Pain Treatment and Chronic Pancreatitis Pain programs at Johns Hopkins Medicine, speaking at the Congress of Clinical Rheumatology West. She emphasized that pain involves both a physical sensation and an emotional response, and that the two are deeply connected through the nervous system.
For patients with rheumatic diseases especially, pain can persist even when the underlying disease is in remission. Speed argued that effective pain management requires a neuromodulatory approach — one that resets the central, peripheral, autonomic, and enteric nervous systems — and that physicians must address both medical and psychiatric contributors to pain.
Key Takeaways:
Why it matters: Chronic pain is one of the most common and costly conditions in the U.S., yet it's often undertreated or mismanaged. A multidisciplinary framework that integrates psychiatric care could meaningfully improve outcomes for millions of patients.
