Chronic pain in Chile: first prevalence report of noncancer chronic pain, fibromyalgia, and neuropathic pain and its associated factors

Durán, Josefina; Tejos-Bravo, Macarena; Cid, Vicente; Ferreccio, Catterina; Calvo, Margarita

doi:10.1097/j.pain.0000000000002886

Cited by 8 publications

(4 citation statements)

References 73 publications

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“…Chronic pain is highly prevalent, affecting around 30% of adults. (Cohen et al, 2021;Duran et al, 2023). It has devastating consequences on the individual who suffers it and society.…”

Section: Evidence Of Regulation Of Chronic Pain By Microbiotamentioning

confidence: 99%

Regulation of Pain Perception by Microbiota in Parkinson Disease

Manjarres,

Calvo,

Pacheco

2023

Pharmacol Rev

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Pain perception involves current stimulation in peripheral nociceptive nerves and the subsequent stimulation of postsynaptic excitatory neurons in the spinal cord.Importantly, in chronic pain, the neural activity of both peripheral nociceptors and postsynaptic neurons in the central nervous system is influenced by several inflammatory mediators produced by the immune system. Growing evidence has indicated that the commensal microbiota plays an active role in regulating pain perception by either acting directly on nociceptors or indirectly through the modulation of the inflammatory activity on immune cells. This symbiotic relationship is mediated by soluble bacterial mediators or intrinsic structural components of bacteria that act on eukaryotic cells, including neurons, microglia, astrocytes, macrophages, T-cells, enterochromaffin cells, and enteric glial cells. The molecular mechanisms involve bacterial molecules that act directly on neurons affecting their excitability, or indirectly on non-neuronal cells inducing changes in the production of pro-inflammatory or anti-inflammatory mediators. Importantly, Parkinson's disease, a neurodegenerative and inflammatory disorder that affect mainly the dopaminergic neurons implicated in the control of voluntary movements, involves not only a motor decline but also non-motor symptomatology, including chronic pain. Of note, several recent studies have shown that Parkinson's disease involves a dysbiosis in the composition of the gut microbiota. In this review, first, we summarize, integrate and classify the molecular mechanisms implicated in the microbiota-mediated regulation of chronic pain. Secondly, we analyze the changes on the commensal microbiota associated to Parkinson's disease and propose how these changes affect the development of chronic pain in this pathology.

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“…Chronic pain is highly prevalent, affecting around 30% of adults. (Cohen et al, 2021;Duran et al, 2023). It has devastating consequences on the individual who suffers it and society.…”

Section: Evidence Of Regulation Of Chronic Pain By Microbiotamentioning

confidence: 99%

Regulation of Pain Perception by Microbiota in Parkinson Disease

Manjarres,

Calvo,

Pacheco

2023

Pharmacol Rev

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“…A su vez, el DC secundario se clasifica en dolor crónico oncológico y dolor crónico no oncológico (DCNO), el que puede ser musculoesquelético (DCME), neuropático (DCN), post traumático, cefálico-orofacial o visceral (Treede et al, 2019). En Chile, la prevalencia del DCNO es 34,7%, siendo más frecuentes el DCME (20%), el DCN (12%) y la fibromialgia (3,9%) (Zitko et al, 2021;Durán et al, 2023).…”

Section: Introductionunclassified

Consideraciones para el uso de tramadol en dolor crónico no oncológico en APS

Martínez Moscoso,

León Sther,

Peñaloza Hidalgo

et al. 2024

ARS med

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Introducción. Tramadol es un analgésico opioide usado frecuentemente para el manejo del dolor crónico no oncológico (DCNO). En Chile, es parte del arsenal farmacológico de los centros de atención primaria para el tratamiento de patologías como artrosis de cadera y rodilla. Es considerado seguro y efectivo, sin embargo, existen reportes de efectos adversos serios por polimorfismos hepáticos, interacciones farmacológicas, intoxicaciones, adicción y muerte. La dosis óptima de tramadol es paciente dependiente. Por esto, es necesario contar con orientaciones específicas para prescribir tramadol de manera segura y eficaz según las características de cada paciente. Materiales y Métodos. Se revisaron guías actualizadas, revisiones sistemáticas y guías de sociedades internacionales sobre el uso de opioides en DCNO y el uso de tramadol en patologías de DCNO como artrosis, lumbago crónico, dolor neuropático y fibromialgia. Resultados. Tramadol no está indicado en el tratamiento de cuadros de dolor primario como fibromialgia y en DCNO secundario es un fármaco de segunda línea o no está recomendado. En dolor crónico neuropático (DCN) es segunda línea de tratamiento. En osteoartritis de cadera, rodilla y mano, se reporta efecto analgésico modesto. Sopesar riesgos versus beneficios en estos pacientes. En artritis reumatoide y lumbago crónico se desaconseja su uso. Conclusiones. Tramadol es un medicamento seguro y efectivo si se indica, administra, supervisa y descontinúa adecuadamente. Sin embargo, puede asociarse a interacciones farmacológicas, efectos secundarios serios, conductas de abuso y usos ilícitos, por lo que es necesario conocer y manejar adecuadamente su farmacología e indicaciones.

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“…Chronic pain conditions (back pain, musculoskeletal disorders, and neck pain) are three of the leading causes for years lost to disability in the last decades [2,3]. Prevalence rates in industrial nations like the USA (20.5 %) [4], Germany (28.3 %) [5], the UK (34 %) [6] and Chile (48.1 %) [7] are high, but also among low-and middle-income countries which prevalence rates ranging from 13% to 49.4% [8]. Chronic pain often results in physical disability, psychological distress, and reduced quality of life [3,9], and is associated with higher rates of divorce and suicide, and affects relationships and self-esteem [10,11].…”

Section: Introductionmentioning

confidence: 99%

Implementation of a Virtual Reality Intervention in Outpatient Physiotherapy for Chronic Pain: Protocol for a Pilot Implementation Study (Preprint)

Elser,

Kopkow,

Schäfer

2024

Preprint

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BACKGROUND Chronic pain is a global health issue that causes physical, psychological, and social disabilities for patients, as well as high costs for societies. Virtual Reality (VR) is a new treatment that provides an opportunity to narrow the gap between clinical practice and recommended care, especially in the outpatient physiotherapy setting. However, there is currently no implementation strategy to integrate VR treatments into this setting. OBJECTIVE This protocol outlines a pilot implementation study that aims to (1) identify barriers and facilitators for implementing a Virtual Reality (VR) intervention in outpatient physiotherapy care for people with chronic pain. And (2) to develop and pilot test an implementation strategy in five practices in Germany. METHODS The study consists of four phases. The first phase involves adapting the treatment protocol of the VR intervention to the local context of outpatient physiotherapy practices in Germany. The second phase includes the collection of barriers and facilitators via semisctructured interviews from physiotherapists and the development of a theory-driven implementation strategy based on the Theoretical Domains Framework (TDF) and the Behavior Change Wheel (BCW). This strategy will be applied in the third phase, which will also include a six-month span of using VR interventions in practices, along with a process evaluation. The fourth phase will be a final evaluation of the entire process and implementation strategy at the end of the of the study. RESULTS The recruitment process and phase 1, including the adaptation of the treatment protocol, have already been completed. We recruited five physiotherapy practices in Lower Saxony, Germany, where the VR intervention will be implemented. The collection of barriers and facilitators through semi-structured interviews is scheduled to begin in February 2024. CONCLUSIONS This pilot implementation study aims to develop a theory-driven implementation strategy for integrating a VR intervention into outpatient physiotherapy care for people with chronic pain. The identified barriers and facilitators, along with the implementation strategy, will serve as a starting point for future randomized controlled implementation studies in different settings to refine the implementation process and integrate VR interventions into the outpatient care of people with chronic pain. CLINICALTRIAL German Clinical Trials Register (ID: DRKS00030862)

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Chronic pain in Chile: first prevalence report of noncancer chronic pain, fibromyalgia, and neuropathic pain and its associated factors

Cited by 8 publications

References 73 publications

Regulation of Pain Perception by Microbiota in Parkinson Disease

Regulation of Pain Perception by Microbiota in Parkinson Disease

Consideraciones para el uso de tramadol en dolor crónico no oncológico en APS

Implementation of a Virtual Reality Intervention in Outpatient Physiotherapy for Chronic Pain: Protocol for a Pilot Implementation Study (Preprint)

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