When patients complain of pain, doctors reach for remedies on a rather dusty shelf. Opium and salicylic acid, discovered centuries ago, have fundamentally shaped practically every pain reliever on the market. Though treatment options for pain have not changed much since the ancient Greeks, an understanding of pain's basic mechanisms has progressed rapidly in the last decade. The optimism among researchers is palpable. "I think it's been unbelievable," says Frank Porreca, professor of pharmacology at the University of Arizona in Tucson. "We've had tremendous breakthroughs."
Yet none of these breakthroughs has translated to new clinical treatments. "The findings add to the burgeoning body of disparate facts pertaining to pain, but are unlikely to trigger new analgesics any time soon," writes pharmacologist Alan Cowan of Temple University in Philadelphia, in an E-mail. Not a single novel class of drugs has emerged from nearly 25 years of bench work, he adds.