Medicines optimization in acute and chronic pain

Berwick, Richard; Frank, Bernhard

doi:10.1016/j.mpaic.2022.03.005

Cited by 1 publication

(5 citation statements)

References 8 publications

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“…Chronic pelvic pain may range from the nociceptive to the nociplastic type of pain, with overlapping phenotypes [ 15 , 37 , 65 , 80 ]. Irritable bowel syndrome is often mentioned when talking about NcplP as well [ 11 , 15 , 37 , 69 , 81 , 82 ].…”

Section: Diseases Associated With Ncplpmentioning

confidence: 99%

“…Chronic headaches often have features of NcplP and can be classified as chronic primary headaches, orofacial pain, tension-type headaches, and migraines [ 14 , 15 , 19 , 46 , 53 , 83 ]. Orofacial pain with the characteristic symptoms of NcplP can be a part of temporomandibular joint dysfunction and burning mouth syndrome [ 8 , 15 , 19 , 22 , 41 , 53 , 82 , 83 , 84 ]. Furthermore, shoulder and neck pain can develop in patients with primary myofascial pain or in breast cancer survivors.…”

Section: Diseases Associated With Ncplpmentioning

confidence: 99%

“…Knowledge about the prevalence and characteristics of NcplP as well as its underlying mechanisms can help in tailoring treatment strategies [ 44 ], although, to date, no gold standard for treating NcplP has been developed [ 34 , 82 ]. The main goal of treatment is to reduce symptoms and improve quality of life [ 64 ].…”

Section: Treatment Of Ncplpmentioning

confidence: 99%

“…TCAs have been reported to be effective in the treatment of NcplP; however, there are some differences across studies. They were reported to be more effective in pain reduction than SNRIs but in older patients, they were associated with a higher risk of adverse effects [ 15 , 43 , 45 , 46 , 82 ]. SNRIs have been reported to have a positive effect on patients with NcplP conditions, even greater than NSAIDs, but unfortunately, clinical research has led to contradictory conclusions.…”

Section: Treatment Of Ncplpmentioning

confidence: 99%

“…SNRIs have been reported to have a positive effect on patients with NcplP conditions, even greater than NSAIDs, but unfortunately, clinical research has led to contradictory conclusions. However, it is important to consider a potential increase in the occurrence of adverse effects [ 15 , 26 , 36 , 43 , 45 , 46 , 82 ]. Some papers report that gabapentinoids may relieve NcplP, whereas others report the opposite results [ 15 , 43 , 46 ].…”

Section: Treatment Of Ncplpmentioning

confidence: 99%

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What Do We Know about Nociplastic Pain?

et al. 2023

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Nociplastic pain is a recently distinguished type of pain, distinct from neuropathic and nociceptive pain, and is well described in the literature. It is often mistaken for central sensitization. Pathophysiology has not been clearly established with regard to alteration of the concentration of spinal fluid elements, the structure of the white and gray matter of the brain, and psychological aspects. Many different diagnostic tools, i.e., the painDETECT and Douleur Neuropathique 4 questionnaires, have been developed to diagnose neuropathic pain, but they can also be applied for nociplastic pain; however, more standardized instruments are still needed in order to assess its occurrence and clinical presentation. Numerous studies have shown that nociplastic pain is present in many different diseases such as fibromyalgia, complex regional pain syndrome type 1, and irritable bowel syndrome. Current pharmacological and nonpharmacological treatments for nociceptive and neuropathic pain are not entirely suitable for treating nociplastic pain. There is an ongoing effort to establish the most efficient way to manage it. The significance of this field has led to several clinical trials being carried out in a short time. The aim of this narrative review was to discuss the currently available evidence on pathophysiology, associated diseases, treatment possibilities, and clinical trials. It is important that physicians widely discuss and acknowledge this relatively new concept in order to provide optimized pain control for patients.

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