Advanced search
1 file | 238.07 KB

Applying modern pain neuroscience in clinical practice : criteria for the classification of central sensitization pain

(2014) PAIN PHYSICIAN. 17(5). p.447-457
Author
Organization
Abstract
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.
Keywords
neuropathic pain, Chronic pain, diagnosis, classification, hypersensitivity, LOW-BACK-PAIN, MECHANISMS-BASED CLASSIFICATIONS, CHRONIC-FATIGUE-SYNDROME, COGNITIVE-BEHAVIORAL THERAPY, CHRONIC MUSCULOSKELETAL PAIN, CHRONIC WIDESPREAD PAIN, NEUROPATHIC PAIN, CHRONIC WHIPLASH, BRAIN ACTIVITY, CENTRAL HYPERSENSITIVITY

Downloads

  • Nijs Modern Pain Neuroscience in Clinical practice Classification CS.pdf
    • full text
    • |
    • open access
    • |
    • PDF
    • |
    • 238.07 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Nijs, Jo, Rafael Torres-Cueco, Paul van Wilgen, Enrique Lluch Girbés, Filip Struyf, Nathalie Roussel, Jessica Van Oosterwijck, et al. 2014. “Applying Modern Pain Neuroscience in Clinical Practice : Criteria for the Classification of Central Sensitization Pain.” Pain Physician 17 (5): 447–457.
APA
Nijs, Jo, Torres-Cueco, R., van Wilgen, P., Lluch Girbés, E., Struyf, F., Roussel, N., Van Oosterwijck, J., et al. (2014). Applying modern pain neuroscience in clinical practice : criteria for the classification of central sensitization pain. PAIN PHYSICIAN, 17(5), 447–457.
Vancouver
1.
Nijs J, Torres-Cueco R, van Wilgen P, Lluch Girbés E, Struyf F, Roussel N, et al. Applying modern pain neuroscience in clinical practice : criteria for the classification of central sensitization pain. PAIN PHYSICIAN. 2014;17(5):447–57.
MLA
Nijs, Jo, Rafael Torres-Cueco, Paul van Wilgen, et al. “Applying Modern Pain Neuroscience in Clinical Practice : Criteria for the Classification of Central Sensitization Pain.” PAIN PHYSICIAN 17.5 (2014): 447–457. Print.
@article{5710389,
  abstract     = {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.},
  author       = {Nijs, Jo and Torres-Cueco, Rafael and van Wilgen, Paul and Lluch Girbés, Enrique and Struyf, Filip and Roussel, Nathalie and Van Oosterwijck, Jessica and Daenen, Liesbeth and Kuppens, Kevin and Vanderweeën, Luc and Hermans, Linda and Beckwée, David and Voogt, Lennard and Clark, Jacqui and Moloney, Niamh and Meeus, Mira},
  issn         = {1533-3159},
  journal      = {PAIN PHYSICIAN},
  keywords     = {neuropathic pain,Chronic pain,diagnosis,classification,hypersensitivity,LOW-BACK-PAIN,MECHANISMS-BASED CLASSIFICATIONS,CHRONIC-FATIGUE-SYNDROME,COGNITIVE-BEHAVIORAL THERAPY,CHRONIC MUSCULOSKELETAL PAIN,CHRONIC WIDESPREAD PAIN,NEUROPATHIC PAIN,CHRONIC WHIPLASH,BRAIN ACTIVITY,CENTRAL HYPERSENSITIVITY},
  language     = {eng},
  number       = {5},
  pages        = {447--457},
  title        = {Applying modern pain neuroscience in clinical practice : criteria for the classification of central sensitization pain},
  volume       = {17},
  year         = {2014},
}

Web of Science
Times cited: