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Do we need a third mechanistic descriptor for chronic pain states?

PainSci » bibliography » Kosek et al 2016
Tags: chronic pain, deep, pain problems

Two articles on PainSci cite Kosek 2016: 1. The 3 Basic Types of Pain2. A Rational Guide to Fibromyalgia

PainSci notes on Kosek 2016:

There is currently no formal classification pain that arises from dysfunction of the nervous system, as opposed to damage to it, or damage to other tissues. Serious disease like fibromyalgia and complex regional pain syndrome are in taxonomic limbo. This interesting paper explores the problem and proposes some solutions. Although it’s fairly readable as scientific papers go, I have covered the same concepts in a much more accessible article: The 3 Basic Types of Pain: Nociceptive, neuropathic, and “other” (and then some more).

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

The redefinition of neuropathic pain, which specifically excludes the concept of “dysfunction,” has left a large group of patients without a valid pathophysiological descriptor for their experience of pain. This group comprises people who have neither obvious activation of nociceptors nor neuropathy (defined as disease or damage of the somatosensory system) but in whom clinical and psychophysical findings suggest altered nociceptive function. Typical such patient groups include those labelled as having fibromyalgia, complex regional pain syndrome (CRPS) type 1, other instances of “musculoskeletal” pain (such as “nonspecific” chronic low-back pain), and “functional” visceral pain disorders (such as irritable bowel syndrome, bladder pain syndrome). The aim of this topical review was to propose, for debate, a third mechanistic descriptor intended for chronic pain characterized by altered nociceptive function.

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