Chronic Pain: A Complex Condition With a Multi-Tangential Approach

Abstract

Chronic pain is known as ongoing pain that lasts longer than three months with increasing healing time. It is approximated that 20% of adults of different sexes, races, and socioeconomic backgrounds fall victim to chronic pain. It is a result of several factors and can have lifelong effects. Pain is a complex matter to measure; therefore, the physician needs to understand the patient’s health state to create a management plan tending to each issue adequately. There are many complications of such pain, and it can interfere terribly with an individual’s quality of life. This article has reviewed the complex pathogenesis of chronic pain and the spectrum of non-pharmacologic modalities and pharmacological treatment options. It has also explored the efficacy of certain drugs and underlined the importance of nonpharmacological options such as physical exercise, cognitive therapy, and physical modalities to treat chronic pain and all the conditions that accompany this disorder.

Using a multimodal approach to manage difficult visceral cancer pain: A case study

“…Therefore, certain analgesics need to penetrate the central nervous system to relieve pain completely and effectively; examples of these are lidocaine infusions and neuromodulators which may be used as a strategy of multimodal treatment. 13 , 14 …”

“…Therefore, certain analgesics need to penetrate the central nervous system to relieve pain completely and effectively; examples of these are lidocaine infusions and neuromodulators which may be used as a strategy of multimodal treatment. 13,14 Although the first line of treatment is the management and titration of the potent opioid, where there is no evidence of superiority of a particular opioid and considering the high incidence of hyperalgesia in cancer abdominal pain, methadone is a good option. 15 Among the adjuvants, the combination of non-steroidal anti-inflammatory drugs or corticosteroids in short cycles may have better results than monotherapy.…”

Dos pensamentos automáticos aos processos álgicos: uma revisão sobre a utilização das terapias cognitivo-comportamentais na abordagem da dor crónica

“…Por outro lado, a intensidade da dor tende a ser dinâmica, com períodos de melhoria e períodos de agravamento que podem estar relacionados com inúmeros fatores, sejam orgânicos ou psicológicos, e que desafiam a intervenção puramente farmacológica. E, nos períodos nos quais a dor não está controlada, frequentemente os indivíduos veem a sua vida absolutamente condicionada pela sua dor e vão perdendo funcionalidade 3 .…”

“…Podem existir casos nos quais a dor crónica está presente, mas já não existe, ou nunca chegou a existir, uma correlação lógica e proporcional com qualquer lesão, processo neoplásico, inflamatório ou infecioso, existente no organismo 1 . Há, portanto, uma tendência atual para se encarar a dor crónica não como um sintoma, mas como uma condição em si mesma 3 .…”

Adolescent morphine exposure changes the endogenous vlPAG opioid response to inflammatory pain in rats

“…If inflammation is not promptly resolved, the resulting pain can become chronic and persist even after the resolution of the inflammation's primary cause. Therefore, it is considered a complex and serious condition (Kela et al., 2021; Ronchetti et al., 2017).…”