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European Pain Federation EFIC

EFIC

We aim to advance research, education, and clinical management of pain and serve as an authoritative, science-based resource on issues related to pain and its treatment.

Lobbying Activity

Meeting with Yvan Verougstraete (Member of the European Parliament, Shadow rapporteur) and European Chemical Industry Council and

27 Jan 2026 · European Competitiveness Fund

Response to EU cardiovascular health plan

15 Sept 2025

The Societal Impact of Pain (SIP) Platform welcomes the European Commissions initiative on a Cardiovascular Health Plan as an important step to strengthen action on non-communicable diseases (NCDs). However, we urge the Commission to adopt a more comprehensive approach by recognising that chronic pain is not only a major NCD burden in its own right, but also a significant determinant of cardiovascular outcomes. Integrating pain prevention and management into cardiovascular policy is essential to achieving Europes NCD policy goals. Chronic pain is the most prevalent health condition in Europe, affecting over 150 million people and representing a leading cause of disability. Its economic burden reaches 34% of EU GDP through healthcare costs, productivity losses, and social exclusion. Beyond these social and economic costs, evidence shows chronic pain directly increases cardiovascular risk. A recent meta-analysis found people with chronic musculoskeletal pain are nearly twice as likely to report cardiovascular disease compared with those without pain. Musculoskeletal conditions such as osteoarthritis also raise the risk of developing CVD, and a doseresponse relationship exists: greater pain intensity is linked to worse cardiovascular outcomes, including higher mortality, cardiac disease, and stroke. Neglecting pain prevention and management thus undermines cardiovascular strategies. Chronic pain and CVD share many modifiable risk factors sedentary behaviour, poor sleep, psychological distress, and low socioeconomic status. Pain is also a frequent symptom or consequence of cardiovascular conditions and their treatments. Moreover, some pain management methods, particularly opioids, may increase the risk of cerebrovascular accidents and ischaemic heart disease. Given the global burden of both opioids and CVD, targeted interventions and integrated care approaches are urgently needed. As highlighted in SIPs 2025 Position Paper on Preventive Healthcare for Chronic Pain, and supported by recent evidence in The Lancet Regional Health Europe, pain prevention must become a public health priority in Europe. Prevention can reduce future healthcare costs and improve both pain-related and cardiovascular outcomes. Effective interventions include structured physical activity, early access to care, and biopsychosocial support, which improve population health resilience. Despite these strong links, chronic pain remains largely absent from EU NCD strategies, including those addressing cardiovascular disease. The upcoming Cardiovascular Health Plan is a key opportunity to close this gap. We urge the Commission to: Recognise chronic pain as a relevant part of the NCD and cardiovascular burden in Europe; Invest in research on the intersections between chronic pain and cardiovascular health, including shared risk factors and co-management strategies, and support longitudinal studies on mechanisms linking pain (e.g. back pain) and CVD; Encourage Member States to develop integrated prevention programmes that address both pain and CVD risk factors; Support the inclusion of pain prevention and management in primary care and community health frameworks. Chronic pain is not only a major public health concern on its own it also directly affects the success of Europes cardiovascular and NCD policy objectives. Recognising and addressing this interconnection will be essential to ensure a people-centred, preventive, and resilient health system for the future. We look forward to working with the Commission and stakeholders across the health community to advance this shared agenda.
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Meeting with Eero Heinäluoma (Member of the European Parliament)

15 Jul 2025 · Impact of pain in policies

Meeting with András Tivadar Kulja (Member of the European Parliament)

4 Jun 2025 · The impact of pain and to influencepolicies

Meeting with Sirpa Pietikäinen (Member of the European Parliament)

4 Jun 2025 · Pain

Meeting with Victor Negrescu (Member of the European Parliament)

4 Jun 2025 · Presentation of Societal Impact of Pain (SIP) Platform

Meeting with Dan-Ştefan Motreanu (Member of the European Parliament)

4 Jun 2025 · The Societal Impact of Pain

Meeting with Kasia Jurczak (Head of Unit Research and Innovation)

31 Jan 2025 · Presentation of the European Pain Federation and exchanges on research funding policies in the current and future framework programmes

Meeting with Vytenis Povilas Andriukaitis (Member of the European Parliament) and European Patients' Forum (EPF)

16 Oct 2024 · EU health policy

Meeting with Marianne Vind (Member of the European Parliament)

10 Oct 2023 · Mental health and chronic pain at work

Meeting with Tomislav Sokol (Member of the European Parliament, Rapporteur)

20 Jul 2023 · EHDS

Meeting with Marianne Vind (Member of the European Parliament)

31 May 2023 · Pain

Meeting with Alex Agius Saliba (Member of the European Parliament)

21 Mar 2023 · The future of European pain research

Meeting with Tomislav Sokol (Member of the European Parliament, Rapporteur)

7 Mar 2023 · European Health Data Space - EHDS

Response to A comprehensive approach to mental health

14 Feb 2023

The Societal Impact of Pain (SIP) Platform calls upon EU and national policymakers to: Incorporate pain assessment into routine assessment of people living with mental health disorders, such as major depression, bipolar disorder, schizophrenia, and substance use disorders. Incorporate pain treatment into mental health treatment plans for people living with mental health disorders, such as major depression, bipolar disorders, schizophrenia, and substance use disorders. Better integrate physical and mental health services, such as treatment of pain and mental health disorders, instead of treating them in isolation in separate services. Provide early access to multimodal pain management programmes for people with a high risk of developing chronic pain and those with chronic pain, to serve as a preventive programme for mental health disorders. Provide training to healthcare professionals in the strong bidirectional relationship between pain and mental health outcomes. Involve people with lived experience of mental health disorders and physical illnesses featuring pain, in developing integrated services. Allocate adequate funding for research on the relationship between mental health and pain. Ensure that the biological, psychological, and social factors of pain are comprehensively addressed in mental health policies. Recognise that good work can have a positive impact on physical health and mental wellbeing and therefore, the reintegration and adaptation of people living with back pain and/or mental health disorders, into the workforce should be supported. Mental health disorders and chronic pain frequently co-occur due to overlapping biological pathways and shared risk factors including poverty, unemployment, high rates of manual labour, and lack of access to mental healthcare services. For instance, depression and pain commonly co-occur, with an estimated co-morbidity rate of 65%. Additionally, pain prevalence is high in people with bipolar disorder, with data showing that 29% of people with bipolar disorder report pain (mainly chronic musculoskeletal pain and migraine) - over double the risk of people without a mental health problem. Moreover, people without a mental health problem are at high risk of developing one if they still have moderate to severe pain after 12 months. Pain, like mental health disorders, is best conceptualised as a biopsychosocial experience. Contemporary management of pain places a large focus on multimodal assessment and treatment, where the biopsychosocial experience is addressed where relevant to each individual patient. To achieve this, patients with chronic pain should have early access to integrated care services involving multiple disciplines. In chronic pain, mental health professionals like psychologists, work as part of a multidisciplinary team to deliver psychosocial interventions such as cognitive behavioural therapies, among other activities. Psychosocial interventions have good evidence of benefit for chronic pain, but many patients do not have access to them. Both pain and mental health disorders cause reduced quality of life, mobility and social participation, across the lifespan. The treatment of mental health disorders is less successful if patients also have chronic pain, and the treatment of chronic pain is less successful if patients also have a mental health disorder. Pain is not routinely assessed and managed in people with mental health disorders, and pain communication and assessment might be obscured by the nature of mental health disorders, such as psychosis. This needs to change as identifying people with mental health disorders, who have or are at risk of experiencing pain, is essential to prevention and early intervention. Recognising and addressing pain in mental health settings and policies may be an untapped avenue for meeting the needs of both patients with chronic pain and mental health disorders. Attached the SIP position on mental health and pain.
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Meeting with Cristian-Silviu Buşoi (Member of the European Parliament, Committee chair)

25 Jan 2023 · European Pain Research Strategy

Meeting with Tomislav Sokol (Member of the European Parliament, Rapporteur) and European Association of E-Pharmacies

22 Nov 2022 · European Health Data Space - EHDS

Response to Europe’s Beating Cancer Plan

2 Mar 2020

Cancer-related pain is a public health priority •Pain is the most common symptom of cancer at diagnosis and rises in prevalence throughout and beyond treatment. •In cancer survivors (where curative treatment was completed), between 33% and 40% suffer from chronic pain, often neuropathic nature. •In advanced cancer (incurable), 1.9 million European cancer patients die from their disease each year. 66% of them will experience pain before death and 55% will experience moderate‐to‐severe intensity pain. The European Pain Federation EFIC would like to contribute to the European Commission’s Beating Cancer Plan with the aim of improving the quality of life of patients with cancer, survivors and carers as well as better treatment and care. Pain is the most common symptom of cancer at diagnosis and rises in prevalence throughout and beyond treatment. Persistent cancer pain can in some individuals lead to the development of chronic widespread pain induced by plastic changes in the sensory nervous system. EFIC therefore believes that pain management must also be addressed under the plan in order to improve quality of life for patients and survivors as well as palliative care and overall treatment. Improved early cancer diagnosis and enhanced treatments continue to enable many patients to live with cancer as a chronic disease. In patients who survive cancer or in those who live with progressive advanced disease, pain is a very common symptom and affects up to 40% of cancer survivors and at least 66% of patients with advanced progressive disease. Between 33% and 40% of cancer survivors suffer from chronic pain and studies have shown that at least one-third of patients are often undertreated due to inadequate attention to pain during regular oncological treatment and unfair or delayed access to opioids. Some of these patients continue to experience pain that negatively affects their quality of life and some patients may continue to use high doses of opioids, which are no longer needed while causing severe side effects. The efforts to enable a good quality of life for cancer patients are multi-professional team efforts rather than one responsible area, and the chronic pain such as that obtained due to post-surgery tissue damage or treatment is often forgotten when accounting for a better quality of life for survivors. Often the surviving cancer patients or patients undergoing cancer treatment are in need of a psychologist, a physical therapist, an oncologist, a radiologist, and a nutritionist among other professions in order to manage their pain both physically and emotionally. It is therefore essential that all healthcare professionals who are involved in the care of patients with cancer-related pain be appropriately trained to complete this assessment, initiate evidence-based treatment and to refer to a competent specialist when needed. The goals of cancer-related pain management should be to reduce the pain and its impact on daily living through tailored treatment, and to increase each patient’s ability for self-management. We at EFIC would like to see the European Commission include pain management from a multi-professional perspective in their roadmap with regards to improving quality of life for patients, survivors, and carers as well as in their treatment and care plan when it comes to access to best treatment for all. We advise the Commission to consider EFIC’s cancer pain standards when formulating the new Beating Cancer Plan. EFIC has developed standards for the management of cancer‐related pain across 37 member countries in Europe. Standards include screening and assessment of pain, tailored management plans that align with the patient’s preferences and goals, and multimodal treatment which reduces the pain and its impact on daily living, including support and advice for self-management. These 10 standards aim to improve cancer pain management, promote the quality of care of patients and reduce variation across Europe.
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