Rome, 13 Nov. (Adnkronos Health) – The management of chronic pain in our country follows very different paths, which change from region to region. There are contexts where the network works, where the patient is not left alone. But there are also situations far behind, where orientation is difficult, where references are missing, where access is neither timely nor fair. What is being done concretely to make the right not to suffer, provided for by law 38 of 2010, real, to transform what today is often a territorial lottery into a system close to the patient? These are the themes of ‘Chronic pain – The commitment of institutions to ensure direct access to treatment’, the fifth and final episode of the vodcast series ‘And you, do you know what it feels like?’, created by Adnkronos in partnership with Sandoz, available on the Adnkronos YouTube channel and on Spotify.
On 25 February 2025, the new Manifesto on chronic pain was signed, defined as Manifesto 2.0, which invites us to move “towards a new awareness of the pathology to guarantee appropriate care of the patient with chronic pain”. Its strength lies not only in its contents, but in the way in which it was born: a true alliance of scientific societies, clinicians, national and regional institutions, companies, healthcare stakeholders, patients and citizens. A synergistic, shared, inclusive work, which finally aims to apply and bring to life a law that we have had in Italy for fifteen years.
The Honorable Ilenia Malavasi, member of the Social Affairs Commission of the Chamber of Deputies, says it clearly: “There is no culture of chronic pain treatment in our country”. This is still the biggest obstacle today. We continue to perceive pain only as a symptom, a consequence of something else. And not as an autonomous, complex, disabling pathology, with an enormous impact on the quality of life. There is also a profound cultural component: “Suffering is not always considered a pathology.” The result is known: late diagnoses, long journeys, improper access. And “there is also a very marked gender factor”: it is often women who live longer without adequate care. For Malavasi, two immediate levers are needed: raising awareness among citizens and training the medical profession, starting from general practitioners, up to specialization schools and dedicated university courses.
In her speech, Tiziana Nicoletti, head of coordination of the Chronic and Rare Disease Association of Cittadinanzattiva, underlines how law 38, despite being “a safeguard of civilization”, is “little known and little applied”. The data that emerges from the Cittadinanzattiva survey is very strong: “70% of citizens do not know the law”. And 60% of these are already suffering from a chronic pathology. It means that those who need to know most do not have the tools to exercise their right. And without information, there is no empowerment. And without empowerment, there is no demand and systems don’t change.
According to Paolo Fedeli, Head of Corporate Affairs at Sandoz, the Manifesto is a tool to highlight what works and to make “plasmatically evident” the value of what is already available, but not yet uniformly accessible. The key, for Fedeli, is not to reinvent: “It is to systematize, integrate, communicate, make centers, territories, training and networks communicate”. And, above all, “ensure that the Regions actually produce coherent strengthening plans”. Malavasi reiterates a key point: “We really need to start again from a transversal training of all healthcare professionals”. Because the patient’s first interlocutor, the family doctor, must recognize chronic pain for what it is and direct it to the right place immediately. “A faster diagnosis – he observes – means less costs, fewer inappropriate waiting lists, fewer pilgrimages between specialists. And it also means clearly distinguishing palliative care and pain therapy, avoiding conceptual overlaps that slow down development and application”.
Nicoletti closes with the appeal to truly include pain therapy within the new structures of the Dm77. Chronic pain is a reality still under construction, still not uniform, still too conditioned by the postal code. But there are tools, there is a law, there are alliances and possible scenarios, as the Vodcast series explains ‘And you, do you know what it feels like? Understanding and dealing with chronic pain’, online on the YouTube channel and in the podcast section of adnkronos.com and on Spotify.
