Abstract
In Sub-Saharan Africa, chronic pain has been an important source of public health problems and, access to conventional pain management therapy is frequently restricted due to cost, availability, and cultural acceptability. In this regard, the principles of traditional medicine and traditional knowledge coupled with the use of plant materials to find solutions remain the primary sources of care among several communities. Nevertheless, in spite of their extensive popularity, the majority of these conventional treatments have not received rigorous scientific scrutiny and thus fail to be integrated into the health care system of contemporary society. In this review, we investigate the major avenues that can be used to integrate traditional and modern medicine when managing chronic pain in Sub-Saharan Africa. It discusses the ethnopharmacological application of widely administered indigenous management, in terms of possible analgesic effects and the sociocultural setting of usages involved. There is focus on how bio-medical research skills like bioassay-guided fractionation, in vivo pain models and pharmacokinetic profiling can be incorporated into community-based participatory research designs to effect validation that is both ethical and culturally appropriate. Regulatory difficulties, intellectual property rights, and policy gaps that block official incorporation and usage of conventional therapies are also portrayed in the review. Also, it proposes establishing translational research centres to work with traditional healers, academic centres, and government-based public health organisations to accelerate the process of identifying and clinically testing potential curative solutions. This review highlights the importance of the indigenous knowledge system in the management of chronic pain through the mapping of a clear and culturally founded translational research agenda to fast track the process of scientific rigor, safety, and efficacy. Finally, mainstreaming of old and tested therapies could be seen as an affordable, culture acceptable and a locally viable solution to the chronic pain burden in the region.

Key words: Chronic pain, translational medicine, indigenous therapies, Sub-Saharan Africa, ethnopharmacology, traditional medicine, pain management, public health