Chronic pain, its management and psychological issues: A review
Chronic pain is one of the most prevalent, disabling conditions both in clinical and psychological aspects and yet often remains inadequately treated
due to cost reasons. Moreover, chronic pain commonly occurs in conjunction with depression, anxiety and somatoform disorders. Chronic and
recurrent pain not associated with a disease is very common in childhood and adolescence, but there are very less studies and analysis has been done
on chronic pain epidemiology and management. As pain is the important factor influencing quality of life and also the reason for which a person seek
the advice of physician even require hospitalization that is why this systematic review highlights the different types of chronic pain, epidemiology,
pathophysiology, and management of chronic pain along with psychological issues associated with it.
Keywords: Pain, Psychological aspects, Epidemiology, Somatoform disord
Debono D J, Hoeksema, LJ, Hobbs, RD. "Caring for Patients with Chronic Pain: Pearls and Pitfalls". Journal of the American Osteopathic Association. 2013; 113 (8): 620â€“627. doi:10.7556/jaoa.2013.023. PMID 23918913.
Turk D C, Okifuji A. "Pain terms and taxonomies". Bonica's management of pain (3 Ed.). Lippincott Williams & Wilkins. 2001 pp. 18â€“25. ISBN 0-683-30462-3.
Kroenke K. Patients presenting with somatic complaints: epidemiology, psychiatric co morbidity and management. Int J Methods Psychiatr Res 2003;12:34â€“43.
Verhaak PF, Kerssens JJ, Dekker J, Sorbi MJ, Bensing JM. Prevalence of chronic benign pain disorder among adults: a review of the literature. Pain 1998; 77:231â€“9.
Sternbach RA. Survey of pain in the United States: The Nuprin Pain Report. Clin J Pain 1986; 2:49â€“53.
Turk DC. Clinical effectiveness and cost-effectiveness of treatments for patients with chronic pain. Clin J Pain 2002; 18:355â€“65.
Smith BH, Elliott AM, Chambers WA, Smith WC, Hannaford PC, Penny K. The impact of chronic pain in the community. Fam Pract 2001; 18:292â€“9.
Ang DC, Kroenke K, McHorney CA. Impact of pain severity and location on health-related quality of life. Rheumatol Int 2006; 26: 567â€“72.
Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain co morbidity: a literature review. Arch Intern Med 2003; 163:2433â€“45.
Ohayon MM, Schatzberg AF. Using chronic pain to predict depressive morbidity in the general population. Arch Gen Psychiatry 2003; 60:39â€“47.
Gureje O, Von Korff M, Simon GE, Gater R. Persistent pain and wellbeing. A World Health Organization Study in primary care. JAMA 1998; 280:147â€“51.
Breivik H. International Association for the Study of Pain: update on WHO-IASP activities. J Pain Symptom Manage 2002; 24:97â€“101.
Keay KA, Clement CI, Bandler R."The neuroanatomy of cardiac nociceptive pathways". In Horst, GJT. The nervous system and the heart. Totowa, New Jersey: Humana Press. 2000; p. 304. ISBN 978-0-89603-693-2.
Coda BA, Bonica JJ. "General considerations of acute pain". In Loeser, D; Bonica, JJ. Bonica's management of pain (3 ed.). Philadelphia: Lippincott Williams & Wilkins. 2001 ISBN 0-443-05683-8.
Bogduk N, Merskey H. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms (second ed.). Seattle: IASP Press. 1994 p. 212. ISBN 0-931092-05-1.
Paice JA. "Mechanisms and management of neuropathic pain in cancer". Journal of supportive oncology 2003; 1 (2): 107â€“20. PMID 15352654.
James L. Henry, Eds. S. Rashiq, D. Schlopflocher, P Taenzer, E. Jonsson , Wiley-Blackwell, Weinheim, Germany. Pathophysiology of Chronic Pain; In: Chronic Pain: a Health Policy Perspective. Health care & disease management. 2008: pp. 59-66
Hansson P. Nociceptive and neurogenic pain. Pharmacia & Upjon AB. 1998 pp. 52â€“63.
Vadivelu N, Sinatra R. "Recent advances in elucidating pain mechanisms". Current Opinion in Anesthesiology 2005; 18 (5): 540â€“7.
Rusanescu G, Mao J. "Notch3 is necessary for neuronal differentiation and maturation in the adult spinal cord". J Cell Mol Med 2014; 18 (10): 2003â€“16. doi:10.1111/jcmm.12362. PMID 25164209.
Sara King , Christine T. Chambers, Anna Huguet, Rebecca C. MacNevin, Patrick J. McGrath, Louise Parker, Amanda J. MacDonald. The epidemiology of chronic pain in children and adolescents revisited: A systematic review. International Association for the Study of Pain. Published by Elsevier B.V. 2011; 152: 2729â€“2738.
Bandell-Hoekstra IE, Abu-Saad HH, Passchier J, Frederiks CM, Feron FJ, Knipschild P. Prevalence and characteristics of headache in Dutch schoolchildren. Eur J Pain 2001; 5:145â€“53.
Sillanpaa M, Anttila P. Increasing prevalence of headache in 7-year-old schoolchildren. Headache 1996; 36:466â€“70.
Bruehl S, Chung OY, Jirjis JN, Biridepalli S. Prevalence of clinical hypertension in patients with chronic pain compared to non pain general medical patients. Clin J Pain 2005; 21(2):147-53.
Whitten CE, Donovan M, Cristobal K. Treating chronic pain: new knowledge, more choices. Permanente J 2005; 9(4):9-18. Accessed 2006 Jan 15.
Thomas A. Cavalieri, DO. Management of Pain in Older Adults. JAOA â€¢ March 2005; 105 (3) Supplement 1: S12 â€“ S17.
AGS Panel on Persistent Pain in Older Persons. The management of persistent pain in older persons. J Am Geriatr Soc. 2002; 50(6 Suppl):S205-S224.
Cavalieri TA. Pain management in the elderly. J Am Osteopath Assoc. 2002; 102:481-485.
Chou, Roger; Huffman, LH; American Pain, Society; American College of, Physicians. "Medications for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline". Annals of Internal Medicine 2007; 147 (7): 505â€“14. doi:10.7326/0003-4819-147-7-200710020-00008. PMID 17909211.
Hardy, Paul A. J. (1997). Chronic pain management: the essentials. U.K.: Greenwich Medical Media. ISBN 1-900151-85-5.
Stanos S, Houle TT. "Multidisciplinary and interdisciplinary management of chronic pain". Physical medicine and rehabilitation clinics of North America 2006; 17 (2): 435â€“50, vii. doi:10.1016/j.pmr.2005.12.004. PMID 16616276.
Ruiz F J."A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies". International Journal of Psychology and Psychological Therapy 2010; 10 (1): 125â€“62.
Chou R, Helfand M, Peterson K, Dana T, Roberts C. Drug Class Review on Cyclo-oxygenase (COX)-2 Inhibitors and Non-steroidal Anti-inflammatory Drugs (NSAIDs). Final Report Update 3. Portland (OR): Oregon Health and Science University; 2006.
Antman EM, Bennett JS, Daugherty A, Furberg C, Roberts H, Taubert KA. Use of nonsteroidal antiinflammatory drugs: an update for clinicians: a scientific statement from the American Heart Association. Circulation 2007; 115:1634â€“42.
Lee C, Straus WL, Balshaw R, Barlas S, Vogel S, Schnitzer TJ. A comparison of the efficacy and safety of nonsteroidal anti-inflammatory agents versus acetaminophen in the treatment of osteoarthritis: a meta-analysis. Arthritis Rheum 2004; 51:746â€“54.
Watkins PB, Kaplowitz N, Slattery JT, Colonese CR, Colucci SV, Stewart PW, et al. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily: a randomized controlled trial. JAMA 2006; 296:87â€“93.
McDiarmid T, Mackler L. What is the addiction risk associated with tramadol? J Fam Pract 2005; 54:72â€“3.
Drugs for pain. Med Lett 2007; 56:23â€“32.
Furlan AD, Sandoval JA, Mailis-Gagnon A, Tunks E. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects. CMAJ 2006; 174:1589â€“94.
Kurt Kroenke, Erin E. Krebs, M.P.H., Matthew J. Bair. Pharmacotherapy of chronic pain: a synthesis of recommendations from systematic reviews. General Hospital Psychiatry 2009; 31: 206â€“219.
Daniell HW. Hypogonadism in men consuming sustained-action oral opioids. J Pain 2002; 3:377â€“84.
Daniell HW. Opioid endocrinopathy in women consuming prescribed sustained-action opioids for control of nonmalignant pain. J Pain 2008; 9:28â€“36.
Hojsted J, Sjogren P. An update on the role of opioids in the management of chronic pain of nonmalignant origin. Curr Opin Anaesthesiol 2007; 20:451â€“5.
Dworkin RH, Backonja M, Rowbotham MC, et al. Advances in neuropathic pain: Diagnosis, mechanisms, and treatment recommendations. Arch Neurol 2003; 60:1524-34.
Kieburtz K, Simpson D, Yiannoutsos C, et al. A randomized trial of amitriptyline and mexiletine for painful neuropathy in HIV infection. AIDS Clinical Trial Group 242 Protocol Team. Neurology 1998; 51:1682-8.
Cardenas DD, Warms CA, Turner JA, Marshall H, Brooke MM, Loeser JD. Efficacy of amitriptyline for relief of pain in spinal cord injury: Results of a randomized controlled trial. Pain 2002; 96:365-73.
Hammack JE, Michalak JC, Loprinzi CL, et al. Phase III evaluation of nortriptyline for alleviation of symptoms of cis-platinum-induced peripheral neuropathy. Pain 2002; 98:195-203.
Jung AC, Staiger T, Sullivan M. The efficacy of selective serotonin reuptake inhibitors for the management of chronic pain. J Gen Intern Med 1997; 12:384â€“9.
Goldstein DJ, Lu Y, Detke MJ, Lee TC, Iyengar S. Duloxetine vs. placebo in patients with painful diabetic neuropathy. Pain 2005; 116: 109â€“18.
Rowbotham M, Goli V, Kunz N, Lei D. Venlafaxine extended release in the treatment of painful diabetic neuropathy: a double-blind, placebo-controlled study. Pain 2004; 110:697â€“706.
Arnold LM, Pritchett YL, D'Souza DN, Kajdasz DK, Iyengar S, Wernicke JF. Duloxetine for the treatment of fibromyalgia in women: pooled results from two randomized, placebo-controlled clinical trials. J Women's Health 2007; 16:1145â€“56.
Markowitz JS, Patrick KS. Venlafaxine-tramadol similarities. Med Hypotheses 1998; 51:167-8.
Galer BS. Neuropathic pain of peripheral origin: Advances in pharmacologic treatment. Neurology 1995;45(Suppl 9):S17-25.
Griffin RS, Woolf CJ. Pharmacology of analgesia. In: Golan DE, ed. Principles of Pharmacology: The Pathophysiologic Basis of Drug Therapy. Philadelphia: Lippincott, Williams and Wilkins, 2005:229-43.
Wiffen PJ, McQuay HJ, Edwards JE, Moore RA. Gabapentin for acute and chronic pain. Cochrane Database Syst Rev 2005: CD005452.
Wiffen PJ, McQuay HJ, Moore RA. Carbamazepine for acute and chronic pain. Cochrane Database Syst Rev 2005:CD005451.
Rice ASC, Maton S, NPS Group. Gabapentin in postherpetic neuralgia: A randomised, double blind, placebo controlled study. Pain 2001;94:215-24
Berde CB. New and old anticonvulsants for management of pain. IASP Newsletter Technical Corner January/February1997:3-5
Chou R, Peterson K. Drug Class Review on Skeletal Muscle Relaxants. Final Report. Portland (OR): Oregon Health and Science University; 2005.
Mason L, Moore RA, Derry S, Edwards JE, McQuay HJ. Systematic review of topical capsaicin for the treatment of chronic pain. BMJ 2004; 328:991â€“4.
Mason L, Moore RA, Edwards JE, McQuay HJ, Derry S, Wiffen PJ. Systematic review of efficacy of topical rubefacients containing salicylates for the treatment of acute and chronic pain. BMJ 2004; 328: 995â€“7.
Underwood M, Ashby D, Cross P, Hennessy E, Letley L, and Martin J, et al. Advice to use topical or oral ibuprofen for chronic knee pain in older people: randomised controlled trial and patient preference study. BMJ 2008; 336:138â€“42.
Portenoy RK. Drug therapy for neuropathic pain. Drug Therapy 1993;23:41-53
Lechin F, van der Dijs B, Lechin M. Pimozide therapy for trigeminal neuralgia. Arch Neurol 1989; 46:960-3.
Graff-Radford SB, Shaw LR, Naliboff BN. Amitriptyline and fluphenazine in the treatment of postherpetic neuralgia. Clin J Pain 2000; 16:188-92.
Glynn C, Oâ€™Sullivan K. A double blind randomized comparison of the effects of epidural clonidine, lignocaine and the combination of clonidine and lignocaine in patients with chronic pain. Pain 1995; 64:337-43.
Rauck RL, Eisenach JC, Jackson K, Young LD, Southern J. Epidural clonidine treatment for refractory RSD. Anesthesiology 1993;79:1163-9)
Eisenach JC, Rauck RL, Buzzanell C. Epidural clonidine analgesia for intractable cancer pain: Phase 1. Anesthesiology 1989;71:647-52.
White A.Editorial Board of Acupuncture in Medicine. Western medical acupuncture: a definition. Acupunct Med. 2009;27(1):33-35
Sherman KJ, Cherkin DC, Eisenberg DM, Erro J, Hrbek A, Deyo RA. The practice of acupuncture: who are the providers and what do they do? Ann Fam Med. 2005;3(2):151-158
Peets JM, Pomeranz B. CXBK mice deficient in opiate receptors show poor electroacupuncture analgesia. Nature. 1978;273(5664):675-676
Zhang WT, Jin Z, Luo F, Zhang L, Zeng YW, Han JS. Evidence from brain imaging with fmri supporting functional specificity of acupoints in humans. Neurosci Lett. 2004;354(1):50-53
Andrew J. Vickers, dphil; Angel M. Cronin, Alexandra C. Maschino, George Lewith, Hugh macpherson, Nadine E. Foster, Karen J. Sherman, Claudia M. Witt, Klaus Linde. Acupuncture for Chronic painindividual Patient Data Meta-analysis FREE Arch Intern Med. 2012; 172(19):1444-1453.
Neilesh S and Philip Wenn Hsin P. Ultrasound-Guided Pain Interventions â€“ A Review of Techniques for Peripheral Nerves Korean J Pain 2013 April; Vol. 26, No. 2: 111-124.
Hayek SM, Hanes MC Intrathecal therapy for chronic pain: current trends and future needs. Curr Pain Headache Rep. 2014 Jan; 18(1):388. doi: 10.1007/s11916-013-0388-x.
Fregni F, Freedman S, Pascual-Leone A. Recent advances in the treatment of chronic pain with non-invasive brain stimulation techniques. Lancet Neurol. 2007 Feb; 6(2):188-91.
Kress HG, Ahlbeck K, Aldington D, Alon E,etal. Managing chronic pain in elderly patients requires a CHANGE of approach. Curr Med Res Opin. 2014 Jun; 30(6):1153-64. doi: 10.1185/03007995.2014.887005. Epub 2014 Mar 6.
JBI Effectiveness of non-pharmacological pain management in relieving chronic pain for children and adolescents Best Practice 14(17) 2010 1-4.
Dawn M. Ehde, Tiara M. Dillworth, and Judith A. Turner. Cognitive-Behavioral Therapy for Individuals With Chronic Pain Efficacy, Innovations, and Directions for Research. American Psychologist. Februaryâ€“March 2014; Vol. 69, No. 2, 153â€“166 DOI: 10.1037/a0035747.
Malaika Babb, Gideon Koren, Adrienne Einarson. Treating pain during pregnancy. Canadian Family Physician â€¢ Le MÃ©decin de famille canadien. 2010; Vol 56:25 â€“ 26.
Fordyce, W. E. (1976). Behavioral methods for chronic pain and illness. St. Louis, MO: Mosby.
Flor H & Turk D C. (2011). Chronic pain: An integrated biobehavioral perspective. Seattle, WA: International Association for the Study of Pain Press.
Gatchel R J, Peng Y B, Peters M L, Fuchs P N& Turk D C. The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin 2007; 133(4), 581â€“624. doi:10.1037/0033-2909.133.4.581.
Turner J. A., & Romano, J. M. (2001). Cognitive-behavioral therapy for chronic pain. In J. D. Loeser & J. J. Bonica (Eds.), Bonicaâ€™s management of pain (3rd ed., pp. 1751â€“1758.). Philadelphia, PA: Lippincott Williams & Wilkins.
Gore M, Sadosky A, Stacey B R, Tai K S & Leslie D. The burden of chronic low back pain: Clinical comorbidities, treatment patterns, and health care costs in usual care settings. Spine, 2012; 37(11), E668â€“E677. doi:10.1097/BRS.0b013e318241e5de
GuzmaÂ´n J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C. Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain. Cochrane Database Syst Rev 2002; CD000963.
L. Scascighini1, V. Toma, S. Dober-Spielmann and H. Sprott. Multidisciplinary treatment for chronic pain: a systematic review of interventions and outcomes. Rheumatology 2008; 47:670â€“678. Advance Access publication 27 March 2008
Gilron I, Bailey JM, Tu D, Holden RR, Weaver DF, Houlden RL. Morphine, gabapentin, or their combination for neuropathic pain. N Engl J Med 2005; 352:1324-34.
Jena S S, Jena M, Patro N, Mishra S, Panda M, Dash M. Patterns of prescription and adr monitoring of drugs in the management of neuropathic pain in a tertiary care teaching hospital. Int J Pharm Pharm Sci,2014; Vol 6, Issue 10, 246-251
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