What is this thing called pain?

Woolf, Clifford J.

doi:10.1172/jci45178

Cited by 457 publications

(332 citation statements)

References 18 publications

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“…[25] Although the neurobiological and psychosocial mechanisms of pain, particularly at an individual level, are not well understood and may be difficult to assess, viewing chronic pain as a single homogenous entity is clearly not helpful. [26] For example, all types of pain do not respond to the same pharmacotherapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to relieve pain due to inflammation or tissue injury in some chronic pain conditions but are generally ineffective for neuropathic pain.…”

Section: Understanding Chronic Painmentioning

confidence: 99%

Rethinking chronic pain in a primary care setting

Stanos

Brodsky

Argoff

et al. 2016

Postgraduate Medicine

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Chronic pain substantially impacts patient function and quality of life and is a burden to society at large in terms of increased health care utilization and loss of productivity. As a result, there is an increasing recognition of chronic pain as a public health crisis. However, there remains wide variability in clinical practices related to the prevention, assessment, and treatment of chronic pain. Certain fundamental aspects of chronic pain are often neglected including the contribution of the psychological, social, and contextual factors associated with chronic pain. Also commonly overlooked is the importance of understanding the likely neurobiological mechanism(s) of the presenting pain and how they can guide treatment selection. Finally, physicians may not recognize the value of using electronic medical records to systematically capture data on pain and its impact on mood, function, and sleep. Such data can be used to monitor onset and maintenance of treatments effects at the patient level and evaluate costs at the systems level. In this review we explain how these factors play a critical role in the development of a coordinated, evidence-based treatment approach tailored to meet specific needs of the patient. We also discuss some practical approaches and techniques that can be implemented by clinicians in order to enhance the assessment and management of individuals with chronic pain in primary care settings. ARTICLE HISTORY

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Section: Understanding Chronic Painmentioning

confidence: 99%

Rethinking chronic pain in a primary care setting

Stanos

Brodsky

Argoff

et al. 2016

Postgraduate Medicine

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“…It is maladaptive and continues even when the stimulus disappears (5). Burning, stinging pain is typically described.…”

Section: Introductionmentioning

confidence: 99%

e association of neuropathic pain and disease activity, functional level, and quality of life in patients with ankylosing spondylitis: a cross-sectional study

2018

Turk J Med Sci

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Background/aim: Increased neuropathic pain (NP) symptoms are seen in rheumatologic diseases such as fibromyalgia, osteoarthritis, and rheumatoid arthritis, but no studies have demonstrated a relationship between ankylosing spondylitis (AS) and NP except for a brain imaging study. The aim of this study was to estimate the presence of NP in patients with AS and to investigate how NP was related to disease activity, functional status, and quality of life.Materials and methods: A total of 100 AS patients (71 males and 29 females; median age: 37 years, range: 18-71 years) were included in the study. Pain (visual analog scale (VAS) and the painDETECT questionnaire), disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), Patient Global Assessment of Disease Activity (PGA), and Ankylosing Spondylitis Disease Activity Score (ASDAS)), functional level (Bath Ankylosing Spondylitis Functional Index (BASFI)), and health-related quality of life (36-Item Short Form Survey (SF-36)) were evaluated. Patients were divided into two groups. Group 1 included patients with possible or likely NP symptoms (painDETECT score of ≥13) and Group 2 included patients without NP symptoms (painDETECT score of <13).Results: Low back pain-VAS, peripheral joint-VAS, BASDAI, PGA, ASDAS, and BASFI scores were significantly higher in Group 1 compared to those of Group 2 (P < 0.05). The SF-36 physical component (PC) score was significantly lower in Group 1 compared to that of Group 2 (P < 0.05). There were no significant differences between the groups regarding SF-36 mental component (MC) scores, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) values and MASES scores. Total painDETECT scores correlated positively with low back pain-VAS, peripheral joint-VAS, morning stiffness-VAS, BASDAI, ASDAS-CRP, ASDAS-ESR, PGA, BASFI, and MASES scores and ESR values, and inversely with SF-36 PC scores. Conclusion:Our results suggest that AS patients should be evaluated in terms of NP in order not to underestimate NP. If clinicians find evidence of likely NP, they should treat the patient with drugs that target NP.

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“…This has provided great impetus to innovations in the prevention, management, and treatment of pain. At the same time, there is abundant evidence that the underlying biology of pain is complex 3 . The mechanisms underlying protective as well as maladaptive and chronic pain point to intricate interplay between the immune and nervous systems 3,4 .…”

Section: Introductionmentioning

confidence: 99%

“…At the same time, there is abundant evidence that the underlying biology of pain is complex 3 . The mechanisms underlying protective as well as maladaptive and chronic pain point to intricate interplay between the immune and nervous systems 3,4 . The elucidation of these mechanisms demands rigorous quantitative, reproducible experimental approaches from molecular dissection to behavioral analysis.…”

Section: Introductionmentioning

confidence: 99%

Measuring Changes in Tactile Sensitivity in the Hind Paw of Mice Using an Electronic von Frey Apparatus

Martinov

Mack

Sykes

et al. 2013

JoVE

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Measuring inflammation-induced changes in thresholds of hind paw withdrawal from mechanical pressure is a useful technique to assess changes in pain perception in rodents. Withdrawal thresholds can be measured first at baseline and then following drug, venom, injury, allergen, or otherwise evoked inflammation by applying an accurate force on very specific areas of the skin. An electronic von Frey apparatus allows precise assessment of mouse hind paw withdrawal thresholds that are not limited by the available filament sizes in contrast to classical von Frey measurements. The ease and rapidity of measurements allow for incorporation of assessment of tactile sensitivity outcomes in diverse models of rapid-onset inflammatory and neuropathic pain as multiple measurements can be taken within a short time period. Experimental measurements for individual rodent subjects can be internally controlled against individual baseline responses and exclusion criteria easily established to standardize baseline responses within and across experimental groups. Thus, measurements using an electronic von Frey apparatus represent a useful modification of the well-established classical von Frey filament-based assays for rodent mechanical allodynia that may also be applied to other nonhuman mammalian models.

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What is this thing called pain?

Cited by 457 publications

References 18 publications

Rethinking chronic pain in a primary care setting

Rethinking chronic pain in a primary care setting

e association of neuropathic pain and disease activity, functional level, and quality of life in patients with ankylosing spondylitis: a cross-sectional study

Measuring Changes in Tactile Sensitivity in the Hind Paw of Mice Using an Electronic von Frey Apparatus

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