3 research outputs found
Applying modern pain neuroscience in clinical practice: criteria for the classification of central sensitization pain
Background: The awareness is growing that central sensitization is of prime importance for the assessment and management of chronic pain, but its classification is challenging clinically since no gold standard method of assessment exists. Objectives: Designing the first set of classification criteria for the classification of central sensitization pain. Methods: A body of evidence from original research papers was used by 18 pain experts from 7 different countries to design the first classification criteria for central sensitization pain. Results: It is proposed that the classification of central sensitization pain entails 2 major steps: the exclusion of neuropathic pain and the differential classification of nociceptive versus central sensitization pain. For the former, the International Association for the study of Pain diagnostic criteria are available for diagnosing or excluding neuropathic pain. For the latter, clinicians are advised to screen their patients for 3 major classification criteria, and use them to complete the classification algorithm for each individual patient with chronic pain. The first and obligatory criterion entails disproportionate pain, implying that the severity of pain and related reported or perceived disability are disproportionate to the nature and extent of injury or pathology (i.e., tissue damage or structural impairments). The 2 remaining criteria are 1) the presence of diffuse pain distribution, allodynia, and hyperalgesia; and 2) hypersensitivity of senses unrelated to the musculoskeletal system (defined as a score of at least 40 on the Central Sensitization Inventory). Limitations: Although based on direct and indirect research findings, the classification algorithm requires experimental testing in future studies. Conclusion: Clinicians can use the proposed classification algorithm for differentiating neuropathic, nociceptive, and central sensitization pain
Applying modern pain neuroscience in clinical practice: criteria for the classification of central sensitization pain
Background: The awareness is growing that central sensitization is of prime importance for the assessment and management of chronic pain, but its classification is challenging clinically since no gold standard method of assessment exists.
Objectives: Designing the first set of classification criteria for the classification of central sensitization pain.
Methods: A body of evidence from original research papers was used by 18 pain experts from 7 different countries to design the first classification criteria for central sensitization pain.
Results: It is proposed that the classification of central sensitization pain entails 2 major steps: the exclusion of neuropathic pain and the differential classification of nociceptive versus central sensitization pain. For the former, the International Association for the Study of Pain diagnostic criteria are available for diagnosing or excluding neuropathic pain. For the latter, clinicians are advised to screen their patients for 3 major classification criteria, and use them to complete the classification algorithm for each individual patient with chronic pain. The first and obligatory criterion entails disproportionate pain, implying that the severity of pain and related reported or perceived disability are disproportionate to the nature and extent of injury or pathology (i.e., tissue damage or structural impairments). The 2 remaining criteria are 1) the presence of diffuse pain distribution, allodynia, and hyperalgesia; and 2) hypersensitivity of senses unrelated to the musculoskeletal system (defined as a score of at least 40 on the Central Sensitization Inventory).
Limitations: Although based on direct and indirect research findings, the classification algorithm requires experimental testing in future studies.
Conclusion: Clinicians can use the proposed classification algorithm for differentiating neuropathic, nociceptive, and central sensitization pain.
Key words: Chronic pain, diagnosis, hypersensitivity, classification, neuropathic pai
Design and preliminarily validation of a tool to assess the impact of chronic nonâcancer pain on peopleâs daily life in Spanishâlanguage: PAIN_Integral Scale ©
Aim: To build and preliminarily validate a Spanish-language
instrument to assess the
impact that CNCP has on the daily lives of people who suffer from it.
Background: The experience of pain is multifactorial and a correct assessment of it
helps to control the intensity of pain. Although there are instruments that evaluate
areas on which Chronic Non-Cancer
Pain impacts, it would be necessary to include
other aspects that scientific literature identifies as relevant.
Design: Instrument and construct cross-sectional
study for psychometric validation.
Methods: A total of 157 items based on items from validated questionnaires were
evaluated by a group of 21 chronic pain experts using Delphi methodology in three
evaluation rounds. A final questionnaire of 55 items with a 5-point
Likert-type
scale
was formed. This questionnaire was piloted on a total of 30 patients to assess their
understanding of the items and the psychometric validation process was carried out
(January to March 2020) on a subsequent sample of 395 people, all of whom attended
Pain Units and Primary Care Centres of the Public Health System in Spain.
Results: The PAIN_Integral Scale© showed acceptable internal consistency scores
measured by Cronbach's alpha. Exploratory Factor Analysis indicated a structure of
nine factors that explain 71.02% of the total variance, from 157 to a final total of 36
items. Confirmatory Factor Analysis showing adequate values confirmed this structure.
The effect size was used to calculate the cut-off
points for the overall scale, setting
them at scores of 130 and 135.
Conclusion: This instrument would allow to assess other constructs and dimensions
not included in the instruments previously available such as treatment compliance,
proactivity, resilience, hopelessness due to pain and pain catastrophizing. However,
despite the fact that the preliminary analysis shows good results, it is necessary to
continue with its validation process in subsequent studies