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Recent Advances in the Management of Chronic Pain
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Recent Advances in the Management of Chronic Pain

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 12418

Special Issue Editor

Dr. Alessandro Vittori

E-Mail Website
Guest Editor
Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy
Interests: pediatric anesthesia; pediatric critical care; pain; pediatric pain; chronic pain; cancer pain; telemedicine; burnout; opioids; health policies; invasive analgesic procedures; acupuncture; artificial intelligence
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Chronic pain represents a difficult, challenge for those dealing with pain, but progress in the field is exciting. Chronic pain is in fact a complex biopsychosocial phenomenon that has important repercussions not only in terms of clinical assistance, but also in terms of social and economic aspects. Different specialists converge on this issue, both in the field of research and in the clinic, with a view to interdisciplinarity. In fact, chronic pain is such a complex phenomenon that it requires the collaboration of several specialists who take care of patients. Recent advances in chronic pain management obviously range from pharmacology, invasive techniques, and psychological interventions to non-pharmacological and unconventional techniques. Furthermore, pain measurement alone and pain relief therapy have proved insufficient. Today, it is necessary to combine the measurement of pain and its treatment with the measurement of quality of life and functional recovery.

Topics will include:

  • Epidemiology of chronic pain;
  • Chronic pain in the pediatric patient;
  • The diagnostic approach;
  • Pain measurement;
  • Neuropathic pain;
  • Headache;
  • The measurement of the quality of life;
  • Functional recovery;
  • The techniques of unconventional medicine;
  • Recent advances in drugs management;
  • Psychological issues;
  • The role of genetics and other mechanisms involved in the development of chronic pain;
  • Artificial intelligence in the management of chronic pain.

Dr. Alessandro Vittori
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic postoperative pain
  • pain mechanisms
  • physiopathology of chronic pain
  • non-invasive analgesic procedures
  • invasive analgesic procedures
  • artificial intelligence and chronic pain
  • opioids
  • cancer pain
  • health policies to combat chronic pain
  • headache

Published Papers (5 papers)

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Editorial

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4 pages, 281 KiB  
Editorial
Editorial to the Special Issue: “Recent Advances in the Management of Chronic Pain”
by Marco Cascella
Int. J. Environ. Res. Public Health 2023, 20(19), 6875; https://doi.org/10.3390/ijerph20196875 - 2 Oct 2023
Viewed by 1253
Abstract
Chronic pain is a complex biopsychosocial phenomenon with far-reaching implications, not only in terms of clinical care but also in the realms of social and economic impact [...] Full article
(This article belongs to the Special Issue Recent Advances in the Management of Chronic Pain)

Research

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17 pages, 691 KiB  
Article
“Working Together”: Perspectives of Healthcare Professionals in Providing Virtual Care to Youth with Chronic Pain during the COVID-19 Pandemic
by Danielle Ruskin, Julia Borsatto, Klaudia Szczech, Monique Tremblay, Lisa N. D’Alessandro, Giulia Mesaroli, Naiyi Sun, Catherine Munns and Jennifer Stinson
Int. J. Environ. Res. Public Health 2023, 20(6), 4757; https://doi.org/10.3390/ijerph20064757 - 8 Mar 2023
Cited by 1 | Viewed by 1432
Abstract
Background: The onset of the coronavirus disease in 2019 necessitated a rapid transition to virtual care for chronic pain treatment. Methods: A mixed methods design was implemented using qualitative interviews and quantitative satisfaction surveys. Interviews were conducted in February 2021 with a sample [...] Read more.
Background: The onset of the coronavirus disease in 2019 necessitated a rapid transition to virtual care for chronic pain treatment. Methods: A mixed methods design was implemented using qualitative interviews and quantitative satisfaction surveys. Interviews were conducted in February 2021 with a sample of healthcare professionals (HCPs; n = 6) who had provided multidisciplinary treatment (MDT) through an outpatient hospital pediatric chronic pain program. Satisfaction surveys were distributed to all MDT professionals employed by the clinic in April 2021 (n = 13 of 20 eligible; 65% response rate). Participants represented medicine, rehabilitation, and mental health professionals. Results: Analysis of interviews generated five themes: (1) adaptation to virtual care, (2) benefits of virtual care, (3) limitations of virtual care, (4) shifting stance on virtual care over time, and (5) considerations for implementing virtual care. The satisfaction survey data revealed that respondents were able to effectively provide appropriate diagnoses, recommendations, and/or care plans for pediatric chronic pain via virtual care (n = 12, 92.3%). Detailed survey responses are presented by discipline. Conclusions: This study provides a rich exploration of HCPs’ experiences in providing MDT for pediatric chronic pain within a virtual care model. The current results may contribute to the future development of guidelines for virtual care delivery with pediatric chronic pain populations. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Chronic Pain)
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11 pages, 351 KiB  
Article
Somatosensory Impairment and Chronic Pain Following Stroke: An Observational Study
by Brendon S. Haslam, David S. Butler, Anthony S. Kim and Leeanne M. Carey
Int. J. Environ. Res. Public Health 2023, 20(2), 906; https://doi.org/10.3390/ijerph20020906 - 4 Jan 2023
Cited by 2 | Viewed by 2588
Abstract
Background: Chronic pain and somatosensory impairment are common following a stroke. It is possible that an interaction exists between pain and somatosensory impairment and that a change in one may influence the other. We therefore investigated the presence of chronic pain and self-reported [...] Read more.
Background: Chronic pain and somatosensory impairment are common following a stroke. It is possible that an interaction exists between pain and somatosensory impairment and that a change in one may influence the other. We therefore investigated the presence of chronic pain and self-reported altered somatosensory ability in individuals with stroke, aiming to determine if chronic pain is more common in stroke survivors with somatosensory impairment than in those without. Methods: Stroke survivors were invited to complete an online survey that included demographics, details of the stroke, presence of chronic pain, and any perceived changes in body sensations post-stroke. Results: Survivors of stroke (n = 489) completed the survey with 308 indicating that they experienced chronic pain and 368 reporting perceived changes in somatosensory function. Individuals with strokes who reported altered somatosensory ability were more likely to experience chronic pain than those who did not (OR = 1.697; 95% CI 1.585, 2.446). Further, this difference was observed for all categories of sensory function that were surveyed (detection of light touch, body position, discrimination of surfaces and temperature, and haptic object recognition). Conclusions: The results point to a new characteristic of chronic pain in strokes, regardless of nature or region of the pain experienced, and raises the potential of somatosensory impairment being a rehabilitation target to improve pain-related outcomes for stroke survivors. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Chronic Pain)

Review

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17 pages, 848 KiB  
Review
Opioid Misuse: A Review of the Main Issues, Challenges, and Strategies
by Helena Biancuzzi, Francesca Dal Mas, Valerio Brescia, Stefano Campostrini, Marco Cascella, Arturo Cuomo, Lorenzo Cobianchi, Ander Dorken-Gallastegi, Anthony Gebran, Haytham M. Kaafarani, Franco Marinangeli, Maurizio Massaro, Angela Renne, Giacomo Scaioli, Rym Bednarova, Alessandro Vittori and Luca Miceli
Int. J. Environ. Res. Public Health 2022, 19(18), 11754; https://doi.org/10.3390/ijerph191811754 - 17 Sep 2022
Cited by 16 | Viewed by 3985
Abstract
In the United States, from 1999 to 2019, opioid overdose, either regularly prescribed or illegally acquired, was the cause of death for nearly 500,000 people. In addition to this pronounced mortality burden that has increased gradually over time, opioid overdose has significant morbidity [...] Read more.
In the United States, from 1999 to 2019, opioid overdose, either regularly prescribed or illegally acquired, was the cause of death for nearly 500,000 people. In addition to this pronounced mortality burden that has increased gradually over time, opioid overdose has significant morbidity with severe risks and side effects. As a result, opioid misuse is a cause for concern and is considered an epidemic. This article examines the trends and consequences of the opioid epidemic presented in recent international literature, reflecting on the causes of this phenomenon and the possible strategies to address it. The detailed analysis of 33 international articles highlights numerous impacts in the social, public health, economic, and political spheres. The prescription opioid epidemic is an almost exclusively North American problem. This phenomenon should be carefully evaluated from a healthcare systems perspective, for consequential risks and harms of aggressive opioid prescription practices for pain management. Appropriate policies are required to manage opioid use and prevent abuse efficiently. Examples of proper policies vary, such as the use of validated questionnaires for the early identification of patients at risk of addiction, the effective use of regional and national prescription monitoring programs, and the proper dissemination and translation of knowledge to highlight the risks of prescription opioid abuse. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Chronic Pain)
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Other

3 pages, 251 KiB  
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Buprenorphine Microdosing Cross Tapers: A Time for Change
by Amer Raheemullah, Ori-Michael Benhamou, Jamie Kuo and Anna Lembke
Int. J. Environ. Res. Public Health 2022, 19(24), 16436; https://doi.org/10.3390/ijerph192416436 - 8 Dec 2022
Cited by 2 | Viewed by 2193
Abstract
Buprenorphine is a partial opioid agonist that is Food and Drug Administration (FDA) approved to treat chronic pain and opioid use disorder (OUD). The national prescribing guidelines in the United States (US) recommend that patients transitioning from full opioid agonists to buprenorphine first [...] Read more.
Buprenorphine is a partial opioid agonist that is Food and Drug Administration (FDA) approved to treat chronic pain and opioid use disorder (OUD). The national prescribing guidelines in the United States (US) recommend that patients transitioning from full opioid agonists to buprenorphine first undergo 12 or more hours of active opioid withdrawal, in order to avoid buprenorphine-precipitated opioid withdrawal. This opioid-free period imposes a significant barrier for many patients. Evidence is accumulating that using microdoses of buprenorphine to cross taper from full-agonist opioids to buprenorphine is a safe and effective way to avoid opioid withdrawal and uncontrolled pain. This microdose cross-tapering strategy is already being used across the US. The US prescribing guidelines and buprenorphine training would benefit from acknowledging this new approach. Additionally, to facilitate this strategy, the FDA should approve transdermal buprenorphine formulations for OUD and manufacturers could produce lower dose formulations of sublingual buprenorphine. The time has come for us to embrace buprenorphine microdosing cross tapers as a new standard of care. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Chronic Pain)
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