Mechanisms and clinical management of pain

Stump, Patrick; Dalben, Gisele da Silva

doi:10.1590/s1806-83242012000700017

Cited by 5 publications

(1 citation statement)

References 7 publications

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“…Other three studies have described the relationship between decreased pharmacological therapy efficacy to control pain as a major factor for discontinuing the drug, without however investigating in more detail psychosocial factors determining non-adherence [16][17][18] . Other studies were also found stressing the importance of considering psychosocial factors when selecting treatments, without however describing such aspects 19 . Among many articles found, several did not address specifically adherence to NP treatment, but would stress the importance of some psychologic aspects influencing non-adherence (e.g., depression) 20 .…”

Section: Discussionmentioning

confidence: 99%

Adhesion to neuropathic pain treatment

2016

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BACKGROUND AND OBJECTIVES:In recent decades the concept of adherence is evolving from one-dimensional approach, limited to following a medication regimen, to the understanding of factors involved in the success or failure of a treatment. In particular, neuropathic pain is characterized by treatment failure associated with high costs. In a recent literature review, non compliance rate with prescriptions for chronic pain ranged from 8 to 62%, and especially for neuropathic pain, the rate was 18%. The objective of this study was to investigate in Pubmed/Medline and Scielo databases publications regarding adherence to neuropathic pain treatment in the last ten years. CONTENTS: Descriptors used were: adherence, pain, neuropathic pain and compliance pain. It can be seen that in most studies (46 articles found in Pubmed and 49 in Scielo) adherence was examined with emphasis on adverse effects or efficacy associated with the use of drugs, or comparing the effects of two medications. Furthermore, 17 articles at Pubmed and 13 articles at Scielo focused on compliance of professionals with guidelines proposed by guideline entities. CONCLUSION:There are a few publications on adherence to neuropathic pain treatment. In general, most researches in this area deal with the effectiveness of medications. Few studies investigate the participation of psychosocial aspects in the adherence process. Given these findings we concluded that it is necessary to produce more knowledge related to this topic, expanding the understanding of this phenomenon considering biopsychosocial aspects. Keywords: Adherence, Compliance, Neuropathic pain, Pain. RESUMO JUSTIFICATIVA E OBJETIVOS:Nas últimas décadas o conceito de adesão vem evoluindo do enfoque unidimensional, limitado a seguimento de um regime farmacológico para a compreensão dos fatores envolvidos no sucesso ou fracasso de um tratamento. Particularmente, a dor neuropática é caracterizada pela falha no tratamento associado a elevados custos. Em recente revisão da literatura, a taxa de não adesão às prescrições para dor crônica variou de 8 a 62%, particularmente na dor neuropática a taxa foi de 18%. O objetivo deste estudo foi investigar nas bases de dados Pubmed/Medline e Scielo as publicações referentes à adesão ao tratamento da dor neuropática nos últimos 10 anos. CONTEÚDO: Os descritores utilizados foram: "adherence", "pain", "neuropathic pain" e "compliance pain". Pode se constatar que a maioria das pesquisas (46 artigos encontrados no Pubmed e 49 no Scielo) examinou a adesão com ênfase no efeito adverso ou eficácia associada ao uso de fármacos, ou comparando os efeitos de dois fármacos. Além disto, foram encontrados 17 artigos no Pubmed e 13 artigos do Scielo, que apresentaram como foco de pesquisa á adesão dos profissionais as diretrizes propostas por entidades "guidelines". CONCLUSÃO: Existe um número reduzido de publicações sobre adesão ao tratamento da dor neuropática. Em geral a maior parte das pesquisas nesta área Adhesion to neuropathic pain treatment INTRODUCTIONNeuropa...

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Section: Discussionmentioning

confidence: 99%

Adhesion to neuropathic pain treatment

2016

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Systematic Review and Synthesis of Mechanism-based Classification Systems for Pain Experienced in the Musculoskeletal System

Shraim

Massé‐Alarie

Hall

et al. 2020

The Clinical Journal of Pain

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Objectives: Improvements in pain management might be achieved by matching treatment to underlying mechanisms for pain persistence. Many authors argue for a mechanism-based classification of pain, but the field is challenged by the wide variation in the proposed terminology, definitions, and typical characteristics. This study aimed to (1) systematically review mechanism-based classifications of pain experienced in the musculoskeletal system; (2) synthesize and thematically analyze classifications, using the International Association for the Study of Pain categories of nociceptive, neuropathic, and nociplastic as an initial foundation; and (3) identify convergence and divergence between categories, terminology, and descriptions of each mechanism-based pain classification. Materials and Methods: Databases were searched for papers that discussed a mechanism-based classification of pain experienced in the musculoskeletal system. Terminology, definitions, underlying neurobiology/pathophysiology, aggravating/easing factors/response to treatment, and pain characteristics were extracted and synthesized on the basis of thematic analysis. Results: From 224 papers, 174 terms referred to pain mechanisms categories. Data synthesis agreed with the broad classification on the basis of ongoing nociceptive input, neuropathic mechanisms, and nociplastic mechanisms (eg, central sensitization). “Mixed,” “other,” and the disputed categories of “sympathetic” and “psychogenic” pain were also identified. Thematic analysis revealed convergence and divergence of opinion on the definitions, underlying neurobiology, and characteristics. Discussion: Some pain categories were defined consistently, and despite the extensive efforts to develop global consensus on pain definitions, disagreement still exists on how each could be defined, subdivided, and their characteristic features that could aid differentiation. These data form a foundation for reaching consensus on classification.

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Health-related Quality of Life and Postural Changes of Spinal Alignment in Female Adolescents Associated With Back Pain in Adolescent Idiopathic Scoliosis

Makino

Kaito

Sakai

et al. 2019

Spine

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Study Design. A prospective cross-sectional study. Objective. To identify risk factors for chronic back pain and back pain at rest in adolescent idiopathic scoliosis (AIS) patients, particularly focusing on the psychological backgrounds of the patients and on postural changes of radiographical parameters for spinal alignment. Summary of Background Data. Back pain has been recognized as a relatively common condition in AIS. However, the effect of patients’ psychological backgrounds and dynamic changes of spinal alignment on back pain are unclear. Methods. One hundred two consecutive female AIS patients (mean age, 14.1 yrs [range, 10–18]) who first visited our outpatient clinic between July 2013 and December 2017 were included. Using SRS-22r questionnaire, the presence of chronic back pain and back pain at rest and the scores of self-image and mental health were evaluated. Using full-length standing and supine posteroanterior radiographs, parameters related to curve profiles and coronal global balance were measured, and postural changes of these parameters were calculated. From full-length standing lateral radiographs, sagittal spinal and spino-pelvic alignment parameters were also measured. Multivariate logistic regression analysis was performed to identify risk factors for back pain. Results. The prevalence of chronic back pain was 22.5% and that of back pain at rest was 25.5%. Poor self-image and mental health scores in SRS-22r were identified as risk factors for chronic back pain. Higher Risser grade, poor self-image score, large postural changes of apical vertebral translation at the main thoracic curve, and hyperlordosis in the lumbar spine were identified as risk factors for back pain at rest. Conclusion. Psychological distress and large postural changes of spinal alignment played an important role in the occurrence of back pain. Physicians should pay more attention to mental healthcare of AIS patients as well as to radiographical assessments of curve severity for better health-related quality of life. Level of Evidence: 4

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Mechanisms and clinical management of pain

Cited by 5 publications

References 7 publications

Adhesion to neuropathic pain treatment

Adhesion to neuropathic pain treatment

Systematic Review and Synthesis of Mechanism-based Classification Systems for Pain Experienced in the Musculoskeletal System

Health-related Quality of Life and Postural Changes of Spinal Alignment in Female Adolescents Associated With Back Pain in Adolescent Idiopathic Scoliosis

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