In a groundbreaking discovery, chronic pain has been shown to be physiologically different from acute pain and now scientists have the roadmap for how to target it.
Researchers from the University of Aberdeen, Academia Sinica in Taiwan and a group of international experts say the discovery brings hope for sufferers of chronic pain and fibromyalgia.
The team identified that in the nervous system chronic pain is processed differently from the pain that comes from an injury or over exertion.
Crucially, they found a new and distinct separate physiological pathway for this chronic type of pain, which means it can now be a target for future therapies.
Dr Guy Bewick, Senior Lecturer in Neurosciences at the University of Aberdeen, explains: “We all know there are different types of pain. There is the sharp stinging pain of pricking your finger with a needle, and there is also the chronic pain of muscle soreness after unaccustomed exercise. Nevertheless, most of us in the West, including scientists, regard both simply as 'pain'. Currently, Western medicine is very often ineffective for chronic pain.
“However, Eastern cultures have differentiated for many centuries, calling the latter 'sng' in Taiwanese, or 'suan tong' (sour pain) in Mandarin. The stinging pain from sharp objects and surgery can usually be treated effectively with common painkillers, but chronic pain often cannot.
“New treatments require an identifiably different drug target. This study has found that target. Specifically, we discovered the mechanism of this pain we call 'sng’.”
The discovery of the new pain pathway is described by the team as ‘a paradigm-shifting discovery that has fundamentally changed our understanding of human sensory systems and challenged the central dogma of pain biology that has been established in the past 50 years.’
Dr Guy Bewick, and his team identified crucial evidence which laid the foundations for the discovery in Taiwan.
Dr Bewick’s team discovered that a molecule called glutamate is released in muscles to activate a highly unusual receptor. This sparked a collaboration with Professor Chen’s team in Taiwan who found that too much glutamate release activated pain nerves nearby making them permanently active and not switch off as they normally would. Crucially, they then discovered that blocking the newly discovered, highly unusual, glutamate receptor entirely stopped the chronic pain being triggered.
Dr Bewick said that: “This discovery means scientists can now start to develop new treatments specifically targeting this new pain pathway which does not respond to standard painkillers.
“This has the potential to help the many people whose pain is currently inadequately treated.”
The wider research was led by Professor Chih-Cheng Chen from Academia Sinica, supported by National Science and Technology Council’s Brain Technology Project and an Investigator Award of Academia Sinica.
They were able to differentiate between the two types of pain by genetically silencing neuronal pathways in a mouse model and then testing the theory in practice in a patient with a spinal cord injury that blocked ‘standard’ pain but spared the newly discovered pathway, in the Taipei Medical University Hospital in Taiwan.
Professor Chen explains: “Fundamentally, we found that sng persists even in people who have lost other pain sensation, for example, a patient with spinal cord damage did not notice when he had broken a toe but could still perceive 'sng' and position in the same leg.
“Clearly, therefore, sng is a separate pathway.
“The identification of a different mechanism for this type of chronic pain is an essential first step to start to develop new treatments specifically targeting this pathway, which does not respond to standard painkillers, to help the many people whose pain is currently inadequately treated.
“This finding could lead to new pain relief treatments for such conditions as fibromyalgia, exercise-induced muscle pain (DOMS), rheumatoid arthritis, and chronic pain after spinal surgery.
“It is a truly ground-breaking discovery in pain research.”
Dr Robert Banks, a Visiting Researcher in Biosciences and the Biophysical Sciences Institute of Durham University, who contributed to this work and who collaborated with Dr Bewick on the fundamental discoveries that led to it, added: “It is very pleasing that a potentially important contribution to human health has developed from our original basic scientific observations.”
Professor Chen added: “With this finding we now have a neurobiological basis of the difference between sng and pain, which annotates a new era of pain medicine.
“Further research into the development of sng-killers and sng management is ushering in a new wave of revolution in the biomedical industry and medical field, as well as bringing hope for millions of patients suffering from intractable sng-type pain.”
Professor Sonia Aitken CEO of Pain Association Scotland added: “Pain Association Scotland welcome this continued research within the field of chronic pain. Such advancing knowledge is essential to fostering innovation, informing thoughtful decision-making, but more importantly, helping to improve the quality of life for those living with chronic pain.”
Marlene Lowe
Marlene Lowe, 35, lives in Aberdeen with her partner, Mark, and their two-year-old springer spaniels, Spock and Cheese.
Marlene describes her experience of living with the chronic pain condition fibromyalgia: “I was first diagnosed with Chronic Fatigue Syndrome (CFS) in my early twenties, after pushing myself through two degrees and several years of debilitating illness. I was sick every couple of weeks with no clear explanation, and for a long time it felt like maybe it was all in my head. When I finally received a diagnosis, I cried—not because there was a solution, but because I finally had validation. It wasn’t just in my imagination.
“That’s the hardest part of living with an invisible illness—or one that makes you invisible by shutting you away from the world. You begin to question everything. It’s hard to think clearly, to trust your instincts, and you constantly feel like your life no longer belongs to you. I once read someone describe CFS as “the illness that takes your life away, but doesn’t have the decency to kill you.” In the early years, that’s exactly how it felt.
“About a decade later, I started experiencing a new kind of pain—something I couldn’t explain away with my CFS, which I’d mostly managed to get under control. Just as I felt I was reclaiming parts of my life, the cycle of doctor’s appointments, symptom tracking, and self-doubt began again. Over and over, I was told it was my weight or my CFS, and no one seemed willing to acknowledge the severity of the pain I was in.
“It was actually my family and friends who first suggested I look into fibromyalgia, and that was the first time I felt a glimmer of hope. At 34, I saw a new GP and arrived with a full list of symptoms and everything I’d been doing to try and help myself. He listened. He believed me. He confirmed it wasn’t just in my head and told me I was already doing everything right. He was so confident in his diagnosis that rheumatology signed it off without even needing an additional assessment. That’s when I learned how far a detailed symptom log and a little self-assurance can go when speaking to doctors.
“This journey can be incredibly lonely. Chronic pain is hard to explain to someone who hasn’t lived it — how you can keep going despite everything hurting, or how the choice to stop feels like giving up entirely. There are days when functioning is an act of defiance, a refusal to surrender to the exhaustion or pain.
“Some medical professionals have been brilliant—really taking the time to listen and treat me like a person, not a puzzle. Others, unfortunately, have been quick to make assumptions. Too often, there’s a rush to explain symptoms away rather than look at the full picture. But when someone takes just a few extra minutes to genuinely engage, it makes all the difference.
“I’ve been lucky. My mother, who also lives with autoimmune conditions, has been my anchor. She helped me find the words when I couldn’t express how I was feeling. Friends who’ve gone through similar experiences have shared what worked for them, and I’ve tried just about everything, from nutritional changes to alternative therapies, in an effort to manage symptoms and reclaim some sense of control. My partner has been unwavering in his support, gently encouraging me to pace myself and always looking for ways to make daily life more manageable. He’s held me up, quite literally, since the fibromyalgia diagnosis.”
Marlene has experience of trying various medications to ease her symptoms: “Pain medication is a complicated area. Most of the time, it doesn’t feel like it makes a significant difference, and ideally, I’d love to live a life free from meds altogether. But that’s not always possible. This path has been one of constant trial and error—trying everything from conventional treatments to alternative approaches, focusing on nutrition, sleep, and gradually improving my fitness where I can.
“A lot of the progress I’ve made has come through self-discovery and community—not through the medical system. And that feels like a missed opportunity, because not everyone has access to the kind of support I’ve been fortunate to have. I honestly don’t know where I’d be without the people in my life who believed me, helped me advocate for myself, and reminded me that I’m not alone.
“I am delighted to see that there is more work being done to try to understand and treat chronic pain conditions and it gives me hope for a pain-free future.”
Dr Rachael Dobson, a GP from Bentley Medical Practice at Redcar Primary Care Hospital who increasingly sees patients living with chronic pain supports the research saying: “Managing chronic pain as a GP is both professionally and emotionally challenging. Every patient’s experience is unique, and finding the right balance of treatment is difficult and time consuming.
“Many patients come to appointments exhausted, frustrated, and often disheartened by the lack of immediate relief, and frequently despite my best efforts, it is often impossible to completely eliminate their pain.
“One of the hardest aspects is managing expectations. Chronic pain is rarely something that can be ‘fixed,’ and helping patients navigate that reality while offering hope takes patience and empathy. It’s a journey of trial and adjustment, and sometimes, just acknowledging the weight of their experience makes all the difference.
“This step towards a new type of painkiller has the potential to transform the lives of the many, many patients living with chronic pain every day.”
The full paper is published in Science Advances.