Chronic Pain in Italy: Exploring Patient Perspectives on Care Gaps and Opportunities

Background : Chronic pain represents a significant public health burden, yet comprehensive data on patient perspectives in Italy remain limited. Despite Law 38/2010 guaranteeing access to pain therapy, gaps persist in understanding how patients experience care, navigate the healthcare system, and access treatment. This study explored patient perspectives on chronic pain management in Italy, examining therapeutic pathways, barriers to care, legal awareness, and unmet needs. Methods : A nationwide cross-sectional survey was conducted between October 31 and November 11, 2025, using Computer-Assisted Web Interviewing (CAWI). Eligible participants were adults (≥18 years) with chronic pain lasting ≥3 months, reporting pain intensity >3 on a Numerical Rating Scale (NRS 0-10) in the preceding week or receiving specific pain therapy. Of 2,989 individuals invited, 492 met inclusion criteria and completed the survey. Data were analyzed using descriptive statistics, with results presented as frequencies and percentages. Results : Participants (53% female, mean age 62 years) reported moderate-to-severe pain intensity (mean NRS 6.2±1.8), with 52% experiencing severe pain (NRS 7-10). Despite this burden, 28% received no specific pain therapy. Among those treated, initial prescribers were pathology specialists (44.1%), general practitioners (42.9%), or pain specialists (13%). Only 22% of patients initially seen by pain specialists continued under their care; conversely, 65% remained with their GP. Chronic pain significantly impacted daily functioning: sleep (74.8%), work/study (75.5%), and caregiving (64.1%). Barriers to care were prevalent: 71.7% experienced difficulty finding competent specialists, 54% encountered medication access problems, and 65.4% lacked clear treatment information. Only 7.5% had good knowledge of Law 38/2010, and 47.6% could not distinguish palliative care from pain therapy. Access to opioid/cannabinoid therapies was considered difficult by 58.8%, attributed to restrictive regulations (58%) and physician reluctance (54.9%). Most participants (74.5%) perceived chronic pain as inadequately addressed in public discourse, and 67.2% felt unsupported by the National Health Service. Conclusions : This study reveals substantial gaps in chronic pain management in Italy, characterized by high rates of untreated pain, limited specialist involvement, poor care continuity, inadequate legal awareness, and perceived institutional neglect. These findings highlight urgent needs for enhanced access to specialized care, improved primary care training in pain management, regulatory reform to facilitate appropriate opioid/cannabinoid prescribing, public awareness campaigns, and patient-centered care pathways. Addressing these challenges requires coordinated action across legislative, clinical, and educational domains to ensure chronic pain is recognized and managed as a distinct disease requiring comprehensive intervention.