Nathan Carroll IL is a Certified Registered Nurse Anesthetist (CRNA) based in Illinois whose practice spans full-scope anesthesia and modern, nonsurgical pain management. Board-certified in nonsurgical pain management and active with the American Association of Nurse Anesthesiologists, he provides pre-operative assessments, individualized anesthetic plans, airway management, and post-operative evaluations, and performs advanced image-guided procedures such as ultrasound- and fluoroscopy-guided nerve blocks, radiofrequency ablation, sympathetic blocks, and joint injections. His services also include labor epidurals, PICC/central/arterial line placement, and diagnostic lumbar punctures, and he contributes to opioid-weaning strategies while serving on the hospital CODE team. This hands-on expertise with conditions like migraines, fibromyalgia, complex regional pain syndrome, facet-generated pain, radiculopathy, joint pain, spasticity, and cancer-related pain grounds his perspective on emerging research and clinical care for chronic pain.
Chronic pain was once viewed only as a symptom of other conditions. Today, researchers recognize it as a disorder of the central nervous system. Recent studies have further linked chronic pain to abdominal fat and gut microbiome patterns, offering new possibilities for diagnosis.
An estimated 100 million Americans live with chronic pain, yet the condition receives only a fraction of available research funding. Studies also show women are disproportionately affected, partly due to higher autoimmune risk and hormonal fluctuations that can intensify pain.
Recognition of chronic pain as a distinct condition has shifted treatment toward tailored management. Pain clinics now employ multidisciplinary care that combines physical therapy, psychological counseling, and input from specialized pharmacists and neurologists. This approach is driving progress toward personalized care for patients with chronic pain.
Currently, researchers have primarily studied chronic pain using mice and other animals to create drugs that might work on humans, but they have found that they are not as effective. Some research focuses on changes at the cellular level that contribute to chronic pain, including a recent project that examined the gut’s role in determining chronic pain.
A research team comprising scientists from Ireland, Israel, and Canada developed AI technology that detects patterns of gut bacteria to identify complex regional pain syndrome (CRPS), a condition that arises in the limb following injury or surgery and can lead to long-term disability. The condition is often more debilitating than the injury that caused it, resulting in swelling and changes in skin color. Across the globe, researchers estimate that between 400,000 and 2.1 million people suffer from CRPS.
The study used machine learning to analyze the gut bacteria of two cohorts, one from Israel and the other from Canada. Researchers trained the algorithm using high-quality microbiome data that accurately predicted CRPS in both cohorts with 90% accuracy. This result is notable, given that geographic, dietary, climatic, and other variations typically create significant differences in microbiome composition. Despite these factors, the AI was able to identify shared patterns in gut bacteria across the two cohorts.
Researchers found that the AI identified common microbiome features, which they described as CRPS signatures, indicating that this tool has uses across varying populations. Additionally, patients whose symptoms resolved after a limb amputation exhibited the same gut pattern. Ultimately, the AI helped researchers understand that individuals with specific gut microbiomes may be more susceptible to developing CRPS.
Another study examined the relationship between abdominal fat and chronic musculoskeletal pain, utilizing data from the UK Biobank. Records from 32,409 patients were analyzed, with women representing 50.8 percent of participants, and the median age being plus or minus seven years. The analysis assessed pain locations and applied various regression models to examine links between visceral and subcutaneous adipose tissue and chronic pain ratios.
Researchers concluded there was a link between the two, suggesting that excessive fat is involved with multisite and widespread chronic pain. In both sexes, the more fat the participant had, the more likely they were to experience chronic pain, with more women experiencing chronic pain.
The study faced several limitations. The pain questionnaire lacked detail on severity, preventing an analysis of how fat levels related to pain intensity. MRI scans to measure fat were conducted only twice, providing insufficient data to capture fluctuations or patterns. Additionally, the relatively small sample size restricted the generalizability of the findings.