Not All Pain is Created Equal: Basic Definitions and Diagnostic Work-Up.
Not All Pain is Created Equal: Basic Definitions and Diagnostic Work-Up.
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DOI：
10.1007/s40122-020-00217-w
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发表时间：
2020-12
期刊：
影响因子：
4
通讯作者：
Ventriglia G
中科院分区：
文献类型：
--
作者：
Bonezzi C;Fornasari D;Cricelli C;Magni A;Ventriglia G
慢性疼痛被世界卫生组织和欧洲卫生机构视为公共卫生优先事项。在残疾、卫生和社会资源消耗以及对初级和专科保健服务的影响方面，这一问题已达到令人震惊的程度。初级保健医生经常被要求管理这种情况。慢性疼痛管理由于其复杂性而具有挑战性。传统上认为它包括持续时间长于正常愈合时间的伤害性疼痛、持续时间超过3个月的神经性疼痛或这些疼痛的组合。最近，增加了第三个描述符，伤害性（原发性）疼痛，用于对慢性疼痛疾病患者进行分类，如纤维肌痛、非特异性背痛或持续的混合性疼痛，或在没有实际或威胁性组织损伤（包括体感神经系统）的情况下，中枢疼痛调节改变导致中枢致敏和慢性疼痛的其他疾病。本文概述了疼痛类型及其潜在机制。疼痛类型的识别有助于成功的疼痛管理。一组诊断工具和疼痛算法，以指导临床医生对正确的诊断。该算法识别可能需要转诊给疼痛专家的病例。一旦确定了疼痛的起源部位（“疼痛发生器”），或怀疑是原发性疼痛综合征，随附文章将提供信息和依据，以支持基于患者特征的治疗决策。
Chronic pain is considered a public health priority by the World Health Organization and European health institutions. It has reached alarming proportions in terms of disability, consumption of health and social resources, and impact on primary and specialist care services. Primary care physicians are often called on to manage this condition. Chronic pain management can be challenging due to its complexity. It has traditionally been considered to include nociceptive pain that that persists longer than the normal healing time, neuropathic pain lasting more than 3 months, or a combination of these. More recently, a third descriptor, nociplastic (primary) pain, was added to classify patients with chronic pain conditions such as fibromyalgia, nonspecific back pain, or mixed pain that persists or other conditions in which altered central pain modulation results in central sensitization and chronic pain in the absence of actual or threatened damage to tissues, including in the somatosensory nervous system. This document provides an overview of pain types and their underlying mechanisms. Successful pain management is facilitated by identification of the pain type. A set of diagnostic tools and a pain algorithm are presented to guide the clinician toward the correct diagnosis. The algorithm identifies cases that may require referral to a pain specialist. Once the site of origin of the pain (the “pain generator”) is identified, or a primary pain syndrome is suspected, the accompanying article provides information and rationale to support treatment decisions based on patient characteristics.
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影响因子：
4
作者：
Bonezzi C;Fornasari D;Cricelli C;Magni A;Ventriglia G
通讯作者：
Ventriglia G
影响因子：
1.4
作者：
Buono, Nicola;Thulesius, Hans;Cambielli, Marco
通讯作者：
Cambielli, Marco
影响因子：
3.6
作者：
Eriksen, J;Sjogren, P;Rasmussen, NK
通讯作者：
Rasmussen, NK
影响因子：
3.1
作者：
DePalma, Michael J.;Ketchum, Jessica M.;Saullo, Thomas
通讯作者：
Saullo, Thomas
影响因子：
7.4
作者：
Bernfort, Lars;Gerdle, Bjoen;Levin, Lars-Ake
通讯作者：
Levin, Lars-Ake