{
  "abstract": "Chronic pain remains one of the leading drivers of disability worldwide, yet the clinical reality is sobering: across nearly all treatments, average benefits are modest, and individual responses are highly variable.1 Part of this gap is definitional and biological: pain can reflect differing relative contributions of peripheral nociceptive drive, central neuroplasticity, and cognitive–affective processes. This is even more relevant in pain conditions without a clearly defined dominant pathophysiological mechanism, where treatment selection is often less targeted and intervention failure is more common. The practical result is that “the average patient” can be a misleading abstraction when underlying pain mechanisms and treatment responses diverge at the individual level. Rather than choosing between mechanistic science and clinical pragmatism, the moment demands parallel progress: advancing mechanism-informed models of pain while simultaneously sharpening clinical decision-making to identify who benefits, who does not, and understanding why. Refining patient selection by identifying mechanisms associated with a lower likelihood of response to anatomically-targeted interventions such as surgery and injections has the potential to improve risk-benefit and cost-effectiveness ratios, which are critical in an era defined by reductions in access to care.",
  "authors": [
    {
      "affiliations": [
        "Anesthesia and Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"
      ],
      "name": "Joana Barroso"
    },
    {
      "affiliations": [
        "Departments of Anesthesiology, Neurology, Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA",
        "Departments of Anesthesiology and Physical Medicine & Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA"
      ],
      "name": "Steven Paul Cohen"
    }
  ],
  "title": "Mechanism-informed pain care: rebalancing procedural care toward better patient selection and outcomes",
  "uid": "7bebd29b-96ca-5a3b-bd60-64df3a69a85f"
}