The IASP classification of chronic pain for ICD-11: chronic secondary visceral pain

Abstract

Chronic visceral pain is a frequent and disabling condition. Despite high prevalence and impact, chronic visceral pain is not represented in ICD-10 in a systematic manner. Chronic secondary visceral pain is chronic pain secondary to an underlying condition originating from internal organs of the head or neck region or of the thoracic, abdominal, or pelvic regions. It can be caused by persistent inflammation, by vascular mechanisms or by mechanical factors. The pain intensity is not necessarily fully correlated with the disease process, and the chronic visceral pain may persist beyond successful treatment of the underlying cause. This article describes how a new classification of chronic secondary visceral pain is intended to facilitate the diagnostic process and to enable the collection of accurate epidemiological data. Furthermore, it is hoped that the new classification will improve the tailoring of patient-centered pain treatment of chronic secondary visceral pain and stimulate research. Chronic secondary visceral pain should be distinguished from chronic primary visceral pain states that are considered diseases in their own right.

Chronic pelvic pain: from correct diagnosis to adequate therapy

“…хроническую первичную тазовую боль, диагностируемую в случае невозможности выявления этиологического фактора; в отношении последнего применяется термин «синдром хронической тазовой боли» (СХТБ) [3,4]. В соответствии с биопсихосоциальной моделью больрезультат динамического взаимодействия биологических, психологических, социокультурных факторов.…”

Critical evaluation of animal models of visceral pain for therapeutics development: A focus on irritable bowel syndrome

“…The quality of visceral pain is frequently described by patients as aching, dull, cramping, sickening, deep, or squeezing. Visceral pain is poorly localized and frequently is associated with autonomic epiphonema such as pallor, sweating, changes in body temperature, or tachycardia . Visceral pain is frequently accompanied by affective complications such as anxiety and emotional distress.…”

“…Visceral pain is poorly localized and frequently is associated with autonomic epiphonema such as pallor, sweating, changes in body temperature, or tachycardia. 18 Visceral pain is frequently accompanied by affective complications such as anxiety and emotional distress. A further characteristic of pain in IBS is that it is associated with crossorgan sensitization of other viscera.…”

Viscero‐visceral hyperalgesia in dysmenorrhoea plus previous urinary calculosis: Role of myofascial trigger points and their injection treatment in the referred area

“…Visceral pain, a major symptom in medicine, is typically referred to somatic structures, mostly the muscle, where most frequently secondary hyperalgesia occurs, as revealed by lowered pain thresholds to different stimuli (Arendt‐Nielsen et al, ; Aziz et al, ; Giamberardino, Affaitati, & Costantini, ; Giamberardino, Affaitati, & Costantini, ; Giamberardino & Vecchiet, ; Jarrell, Giamberardino, Robert, & Nasr‐Esfahani, ; Jarrell et al, ; Treede et al, ). Visceral pain syndromes very frequently co‐occur in the same patients and when two viscera are affected, sharing at least part of their central sensory projection, an enhancement of spontaneous pain and referred hyperalgesia from both viscera occur (viscero‐visceral hyperalgesia‐VVH), a phenomenon mainly attributed to sensitization of viscero‐viscero‐somatic convergent neurons whereby nociceptive inputs from one visceral organ enhance the central responses to inputs from the second organ and somatic area of referral (Brumovsky & Gebhart, ; Frøkjaer et al, ; Giamberardino, ; Giamberardino, Costantini, et al, ; Giamberardino et al, ; ; Iuvone et al, ; Lopopolo et al, ; Malykhina, ; Marson, Giamberardino, Costantini, Czakanski, & Wesselmann, ).…”