THE GUT microbiome may hold untapped potential in managing pain related to orthopaedic conditions, according to a new integrative review that highlights its emerging role in modulating inflammation and neurological pathways. The review examines growing evidence linking gut dysbiosis to pain mechanisms and suggests that targeting the microbiome could offer a novel approach to pain care in musculoskeletal health.
Through the lens of the gut-brain axis, the authors explore how the microbiome influences nociceptive and neuroinflammatory responses that contribute to chronic pain and central sensitization. The review emphasizes how microbial metabolites and short-chain fatty acids play a key role in shaping neuroinflammation and pain perception. These mechanisms suggest a deeper interplay between the gut ecosystem and the nervous system than previously recognized.
Advancements in meta-omics technologies such as metagenomics and metaproteomics have allowed for more detailed profiling of microbiome-host interactions. This has led to a greater understanding of how microbial composition affects systemic immune responses and pain modulation, especially in patients with orthopaedic conditions.
The authors review potential therapeutic strategies that include probiotics, prebiotics, synbiotics, and faecal microbiome transplants. These interventions aim to recalibrate the gut microbiome and potentially reduce the need for opioid-based pain treatments. While promising, the clinical translation of these therapies is complicated by the high variability in individual microbiomes and the current lack of standardized treatment protocols.
Ultimately, the review calls for a multidisciplinary approach combining microbiology, immunology, neurology, and orthopaedics to develop personalized strategies for managing pain through gut health. With further research and clinical validation, microbiome modulation may represent a paradigm shift in orthopaedic pain management.
Reference:
Jeyaraman N et al. Integrative review of the gut microbiome’s role in pain management for orthopaedic conditions. World J Exp Med. 2025;15(2):102969.
