Chronic Pain: An Update of Clinical Practices and Advances in Chronic Pain Management

Abstract

Chronic pain affects a significant amount of the population and represents a heavy personal and socioeconomic burden. Chronic pain mechanisms can be categorized as nociceptive, neuropathic, or nociplastic. Although mechanism-based pain treatment is optimal, different types of pain mechanisms may overlap in patients. Recently, the biopsychosocial model with the multidisciplinary pain management program is widely accepted as one of the most effective methods to assess and manage chronic pain. The treatment of chronic pain consists of a personalized, stepwise, and multimodal approach that includes pharmacotherapy, psychotherapy, integrative treatments, and interventional procedures. Somatic and peripheral nerve blocks for the treatment of chronic pain are often deferred. With the increasing use of ultrasound in pain medicine, newly defined interfascial plane blocks, which may be performed alone or as an adjuvant to multimodal management, have gained popularity. Adequate pain management can improve physical functioning, mental health and quality of life indicators, and reduce pain chronification. The aim of this current article is to perform a comprehensive and updated review of existing treatment options, particularly interfascial plane blocks in chronic pain syndromes.

Erector Spinae Plane Block and Chronic Pain: An Updated Review and Possible Future Directions

“…Regional anesthesia, which involves the injection of local anesthetics near nerves or nerve roots, can play a significant role in the management of chronic pain [ 25 ]. This technique can be used to block pain signals from specific areas of the body, providing targeted pain relief without the side effects associated with systemic pain medications.…”

Pain. Organisational and Educational Concept

“…Ці аспекти посилюють проблему соціального стану виключення пацієнтів, що є важливою частиною страждання пацієнтів з хронічним болем. Хронічний біль є складним біо-психо-соціальним феноменом із далекосяжними наслідками не лише з точки зору клінічної допомоги, але й у сфері соціального та економічного впливу [7,8,9]. Це становить величезний виклик для тих, хто займається лікуванням болю.…”

Pain and function in patients with chronic low back pain and leg pain after Zhineng Qigong – a quasi-experimental feasibility study

“…Spine-related pain can be classified into the pain types nociceptive, referred, and neuropathic, where a patient can suffer from a combination of types [ 4 ]. Nociceptive pain arises from activation of nociceptors secondary to actual or impending damage to non-neural structures [ 5 ] such as from the disc, facet, sacroiliac joint, ligaments, and muscles [ 4 ]. Referred pain is perceived at a remote location from the injury, being a segmental component of nociceptive pain.…”

“…Referred pain is perceived at a remote location from the injury, being a segmental component of nociceptive pain. Neuropathic pain is caused by pathology or a lesion in the somatosensory nervous system [ 5 ] affecting a spinal nerve root and/or dorsal root ganglion [ 4 ]. Radicular pain is a manifestation of neuropathic pain, and radiculopathy is a set of symptoms caused by nerve root pathology [ 4 , 6 ], also called sciatica [ 6 ].…”