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

Abstract

Chronic musculoskeletal pain is defined as chronic pain arising from musculoskeletal structures such as bones or joints. Although comprising the most prevalent set of chronic pain conditions, it was not represented appropriately in the 10th edition of the International Classification of Diseases (ICD-10), which was organized mainly according to anatomical sites, was strongly focused on musculoskeletal disease or local damage, and did not consider the underlying mechanisms of pain. The new ICD-11 classification introduces the concept of chronic primary and secondary musculoskeletal pain, and integrates the biomedical axis with the psychological and social axes that comprise the complex experience of chronic musculoskeletal pain. Chronic primary musculoskeletal pain is a condition in its own right, not better accounted for by a specific classified disease. Chronic secondary musculoskeletal pain is a symptom that arises from an underlying disease classified elsewhere. Such secondary musculoskeletal pain originates in persistent nociception in musculoskeletal structures from local or systemic etiologies, or it may be related to deep somatic lesions. It can be caused by inflammation, by structural changes, or by biomechanical consequences of diseases of the nervous system. It is intended that this new classification will facilitate access to patient-centered multimodal pain management and promote research through more accurate epidemiological analyses.

Effectiveness of motor imagery and action observation training on musculoskeletal pain intensity: A systematic review and meta‐analysis

“…The subjects were patients with acute or chronic musculoskeletal pain. Pain is regarded as chronic when it lasts or recurs for more than 3 to 6 months and is defined as persistent or recurrent pain that arises as part of a disease process directly affecting bone(s), joint(s), muscle(s) or related soft tissue(s), in accordance with International Association for the Study of Pain (IASP; Perrot et al, ; Treede et al, ). The patient's sex was irrelevant.…”

Altered interoceptive perception and the effects of interoceptive analgesia in musculoskeletal, primary, and neuropathic chronic pain conditions.

“…Chronic secondary musculoskeletal pain (SMP) is a condition that arises either from an underlying disease "related to chronic nociception originating in the vertebral column, joints, bones, muscles, tendons and related soft tissues, from local or systemic aetiologies (and) also related to deep somatic lesions" or to diseases of the nervous system that may cause musculoskeletal pain [64].…”

Dietary Patterns and Interventions to Alleviate Chronic Pain

“…Western diet imbalance also yields fewer anti-inflammatory mediators, including antioxidants and antioxidant defense. The composition of a western-style diet may not necessarily increase inflammation directly but rather induce a reduction in anti-inflammatory defense [ 17 , 18 , 19 ]. Chronic pain often results from a persistent proinflammatory state [ 20 ].…”