Microbiome First Approaches in Pain Prevention and Management

The Microbiome First Initiative aims to facilitate sustainable healthcare by focusing first and foremost on the human holobiont majority, the microbiome. Understanding how the human microbiome affects not only risk of disease but also human perceptions can help individuals thrive and pave the way for a healthy life course. Following a recent review of Microbiome First Medicine the context of health and safety, this present opinion article considers the role of the human microbiome, particularly the gut microbiome, on pain, sensory perceptions, and the prevention and multimodal management of pain. Microbial dysbiosis can be causative of some forms of immune-inflammatory and neurologic pain and the altered human microbiome can lock in the pain while at the same time interfering with analgesic/opioid therapies. Dysbiotic microbiota can make drug treatments less effective and with opioids, the microbes can significantly increase: For these reasons, it is critical to move beyond simply thinking about the microbiome in dealing with pain to considering the microbiome as central in multimodal pain prevention and management strategies. The microbiome is key in any attempts to change physiology, metabolism, systems biology function, and receptor-based perceptions within the human body.