Chronic musculoskeletal pain. Leading symptom or comorbid pathology?

Abstract

Current trends in the development of personalized medicine dictate the need to interpret chronic pain as a multifactorial biopsychosocial phenomenon. A comprehensive integrated approach to the management of patients with chronic pain includes nosological diagnostics, assessment of factors that determine the persistence of pain and comorbid pathology, and the use of necessary pharmacological and non-pharmacological methods of treatment. Currently, primarily non-steroidal anti-inflammatory drugs are used for the pharmacotherapy of chronic pain, which is predominantly nociceptive in nature. Meloxicam (Movalis®), along with high efficacy, has a favorable safety profile and has proven itself in the treatment of chronic musculoskeletal pain. For chronic pain associated predominantly with neuropathy and central sensitization, the drugs of choice are tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitor duloxetine, the α2δ ligands pregabalin and gabapentin.