2020 foresight: Envisioning therapeutic innovations for pain

The explosion in scientific knowledge since the completion of the draft human genome sequence 10 years ago illustrates the quantum leap that is possible when emerging technology is focused on an important scientific question. We are now on the threshold of the next decade that holds the potential for translating our increased understanding of the molecular-genetic processes that form the basis for pain processing and analgesic mechanisms. This article attempts to envision the therapeutic innovations for pain based on translating genomic findings into new approaches to pain management, identifying epigenetic targets for analgesia, and finally moving from a century-old search for a single ‘magic bullet’ among derivatives of opium and will bark to new molecular entities engaging novel targets and multiple pathways that interact with the complex processes that modulate pain and its transition to chronicity.