Basic guide to chronic pain assessment: from neurophysiology to bedside

Maurizio Evangelista, Gabriele Finco, Salvatore Sardo

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

2 Citazioni (Scopus)

Abstract

Chronic musculoskeletal pain is a highly prevalent condition that is commonly encountered in both general and special- ist practice. Nonetheless, it still represents a significant challenge to the practitioners because of the lack of substantial evidence-based guidance. This review aimed to summarize the main pathophysiological mechanisms of chronic pain of- fering a mechanism-oriented approach to diagnosis and management. We believe that a basic knowledge of the physical signs and symptoms of these mechanisms could empower the clinician to choose appropriate medication and identify high-risk pain patients. Central sensitization and neuropathic features may arise in previously nociceptive and inflammatory pain syndromes. Central sensitization is a functional remodeling of the spinal cord, where light touch afferents are recruited by nociceptive second-order neurons. Neuropathic features include both negative signs, such as reduced percep- tion of vibration and touch, and positive symptoms, such as paroxysmal electric shock pain, due to ectopic discharge. These phenomena are the neurobiological basis of the commonly defined refractory chronic pain. Early detection and specific treatment of these mechanisms are required in order to restrain the reinforcement of pronociceptive remodeling of the nervous system
Lingua originaleEnglish
pagine (da-a)1321-1330
Numero di pagine10
RivistaMINERVA ANESTESIOLOGICA
Volume86
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Musculoskeletal pain
  • Neuralgia
  • Physiology
  • Therapy

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