A classification of chronic pain for ICD-11

Treede, R.‐D.; Rief, Winfried; Barke, Antonia; Aziz, Qasim; Bennett, Mike; Benoliel, Rafael; Cohen, Milton; Evers, Stefan; Finnerup, Nanna Brix; First, Michael B.; Giamberardino, Maria Adele; Kaasa, Stein; Kosek, Eva; Lavand’homme, Patricia; Nicholas, Michael K.; Perrot, Serge; Scholz, Joachim; Schug, Stephan A.; Smith, Blair H.; Svensson, Peter; Vlaeyen, Johan W.S.; Wang, Shuu Jiun

doi:10.1097/j.pain.0000000000000160

Cited by 2,005 publications

(1,534 citation statements)

References 30 publications

(30 reference statements)

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“…Nociceptive pain is the predominant type of pain in individuals with osteoarthritis (OA), rheumatoid arthritis (RA), neck and back pain with structural pathology, and chronic tendonitis or bursitis, among others ( Figure 1). [3] Prolonged nociceptive pain can lead to peripheral sensitization, which describes a process whereby tissue damage causes release of chemical substances such as bradykinin, prostaglandins, leukotrienes, and substance P that increase the sensitivity of peripheral neurons to noxious stimuli by lowering neuronal activation thresholds and increasing firing rates. The clinical consequences are hyperalgesia (greater levels of perceived pain in response to painful stimuli) and allodynia (pain in response to stimuli such as touch which normally do not evoke pain) in tissues sensitized by this process.…”

Section: Understanding Chronic Painmentioning

confidence: 99%

“…Although some of these conditions are predominantly nociceptive in nature and respond to NSAIDs, many represent a mixed pain condition. [3] Ischemic pain is defined as pain associated with insufficient blood flow due to obstruction, injury, or trauma. This classification of pain is present in conditions such as peripheral arterial disease and can progress from predominantly nociceptive in nature to having a significant neuropathic component.…”

Section: Understanding Chronic Painmentioning

confidence: 99%

“…[1] In contrast, chronic pain persists long after we would expect the apparent cause of the pain to have resolved. [2,3] Chronic pain can present without evidence of, and out of proportion to, overt physical damage. Thus, chronic pain may be viewed as a distinct condition associated with pathological changes occurring in the central nervous system (CNS) rather than merely a symptom of another disorder.…”

Section: Introductionmentioning

confidence: 99%

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Rethinking chronic pain in a primary care setting

Stanos

Brodsky

Argoff

et al. 2016

Postgraduate Medicine

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Chronic pain substantially impacts patient function and quality of life and is a burden to society at large in terms of increased health care utilization and loss of productivity. As a result, there is an increasing recognition of chronic pain as a public health crisis. However, there remains wide variability in clinical practices related to the prevention, assessment, and treatment of chronic pain. Certain fundamental aspects of chronic pain are often neglected including the contribution of the psychological, social, and contextual factors associated with chronic pain. Also commonly overlooked is the importance of understanding the likely neurobiological mechanism(s) of the presenting pain and how they can guide treatment selection. Finally, physicians may not recognize the value of using electronic medical records to systematically capture data on pain and its impact on mood, function, and sleep. Such data can be used to monitor onset and maintenance of treatments effects at the patient level and evaluate costs at the systems level. In this review we explain how these factors play a critical role in the development of a coordinated, evidence-based treatment approach tailored to meet specific needs of the patient. We also discuss some practical approaches and techniques that can be implemented by clinicians in order to enhance the assessment and management of individuals with chronic pain in primary care settings. ARTICLE HISTORY

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Section: Understanding Chronic Painmentioning

confidence: 99%

Section: Understanding Chronic Painmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Rethinking chronic pain in a primary care setting

Stanos

Brodsky

Argoff

et al. 2016

Postgraduate Medicine

View full text Add to dashboard Cite

show abstract

“…4) Use of medications, for both groups. 5) Both groups were submitted to neuropsychological evaluation by the Montreal Cognitive Assessment (MoCA) test 19,20 validated for Portuguese, and Stroop Victoria Test (ST) 21 ( for attention and working memory). We used Verbal Fluency (VF) and Clock Drawing (CD) as part of the MoCA.…”

Section: Data Investigatedmentioning

confidence: 99%

Cognitive deficits in chronic pain patients, in a brief screening test, are independent of comorbidities and medication use

Ferreira

Oliver

Thomaz

et al. 2016

Arq. Neuro-Psiquiatr.

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Objective To describe and analyze cognitive aspects in patients with chronic pain and a control group without pain. Method A case-control study was conducted on 45 patients with chronic pain and on 45 control subjects. Data including pain diagnosis, comorbidities and medication used, were evaluated. Cognitive tests, such as the Montreal Cognitive Assessment (MoCA), Verbal Fluency Test, Clock Drawing Test and Stroop Test, were applied. Results Patients with chronic pain showed a poorer performance, as shown by the scores of the MoCA test (p < 0.002), Verbal Fluency Test (p < 0.001), Clock Drawing Test (p = 0.022) and Stroop Test (p < 0.000). Chronic pain variable (p = 0.015, linear regression model) was an independent factor for results obtained with the MoCA. Conclusion Patients with chronic pain showed a poorer performance in a brief screening test for cognitive impairment not related to confounding variables, as comorbidities and pain-medication use.

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“…Chronic pain is a condition in which the main symptom is persistent pain for more than 3 months after the acute phase [1]. In Japan, 13.4% of the general population (approximately 17 million people) experience this symptom [2].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder in Patients with Chronic Pain

Kasahara¹,

Okamura²,

Matsudaira³

et al. 2017

OJPsych

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Aims: To investigate rates of attention-deficit hyperactivity disorder (ADHD) in patients with chronic pain attending a pain clinic, the effects of a screening measure for ADHD in patients with chronic pain, and the effects of ADHD drugs on both pain and ADHD symptoms. Methods: We retrospectively surveyed 110 patients with chronic pain visiting the Anesthesiology and Pain Relief Center at the University of Tokyo in Japan, who had also consulted a psychiatrist, between April 2012 and July 2015. Results: Of the total of 110 patients with chronic pain, 35 (31.8%) were also diagnosed with ADHD, and the average Wender Utah Rating Scale (WURS) score among the ADHD patients was 39.0 ± 22.1 (n = 25). Only 36.0% of these patients exceeded the cutoff value, suggesting that 64.0% of the patients with ADHD were not identified by screening with the WURS. Twenty-six patients initiated treatment with ADHD medication, with dosage adjustment completed in 21. Of these 21 patients 20 (95.0%) had improved ADHD symptoms. Improved pain symptoms were observed in 14 patients (66.6%), with a reduction in the pain numerical rating scale of 64.7% ± 30.1%. Conclusions: This is the first study investigating the comorbidity of ADHD and chronic pain at pain clinics showing a high level of comorbidity and amelioration of pain and ADHD symptoms with treatment. Careful interpretation is required when the WURS is used to screen patients with chronic pain.

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A classification of chronic pain for ICD-11

Cited by 2,005 publications

References 30 publications

Rethinking chronic pain in a primary care setting

Rethinking chronic pain in a primary care setting

Cognitive deficits in chronic pain patients, in a brief screening test, are independent of comorbidities and medication use

Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder in Patients with Chronic Pain

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