Chronic Pain

A special issue of Journal of Personalized Medicine (ISSN 2075-4426).

Deadline for manuscript submissions: closed (20 December 2020) | Viewed by 19540

Special Issue Editor


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Guest Editor
Department of Anesthesia, McMaster University, Hamilton, ON, Canada
Interests: chronic pain management; pharmacogenetics of mental health conditions; chronic disease management; healtheconomic impact of pharmacogenetics

Special Issue Information

Dear Colleagues,

The Clinical Pharmacogenetics Consortium (CPIC) provided guidelines on stratification of pro-opioids based on CYP2D6 function, suggesting generalized recommendations for poor and ultrarapid metabolizers. Variations in other genes have been implicated in determining response to opioids, including OPRM1, COMT, and ABCC1; however, no clinical guidelines or protocols have been developed. Upcoming CPIC recommendations expand on the role of variations in the CYP2C9 on NSAIDs. Alternative non-opioid treatment options for chronic pain include SNRIs, TCAs, antiepileptics, and cannabinoids, yet clinical protocols for evidence-based management of chronic pain have not been detailed for various types of chronic pain conditions, such as cancer pain, fibromyalgia, arthritis, IBD, and neuropathic pain. The Journal of Personalized Medicine is now opening a Special Issue that is fully devoted to evidence-based chronic pain management, with a call for papers involving basic, translational, and clinical research on this topic.

Dr. Ruslan Dorfman
Guest Editor

Manuscript Submission Information

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Keywords

  • chronic pain
  • acute pain
  • drug metabolism
  • drug transporters
  • pharmacokinetics
  • pharmacodynamic
  • opioids
  • NSIADs
  • SNRIs
  • TCAs
  • cannabinoids

Published Papers (4 papers)

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Research

11 pages, 669 KiB  
Article
Pain Standards for Accredited Healthcare Organizations (ACDON Project): A Mixed Methods Study
by Concepción Pérez, Jimmy Martin-Delgado, Mercedes Vinuesa, Pedro J. Ibor, Mercedes Guilabert, José Gomez, Carmen Beato, Juana Sánchez-Jiménez, Ignacio Velázquez, Claudio Calvo-Espinos, María L. Cánovas, José A. Yáñez, Mireia Rodríguez, José L. Baquero, Elisa Gallach, Emma Folch, Albert Tuca, Manel Santiña and José J. Mira
J. Pers. Med. 2021, 11(2), 102; https://doi.org/10.3390/jpm11020102 - 05 Feb 2021
Cited by 1 | Viewed by 3687
Abstract
Up to 50% of cancer patients and up to 90% of those in terminal stages experience pain associated with disease progression, poor quality of life, and social impact on caregivers. This study aimed to establish standards for the accreditation of oncological pain management [...] Read more.
Up to 50% of cancer patients and up to 90% of those in terminal stages experience pain associated with disease progression, poor quality of life, and social impact on caregivers. This study aimed to establish standards for the accreditation of oncological pain management in healthcare organizations. A mixed methods approach was used. First, a pragmatic literature review was conducted. Second, consensus between professionals and patients was reached using the Nominal Group and Delphi technique in a step that involved anesthesiologists, oncologists, family physicians, nurses, psychologists, patient representatives, and caregivers. Third, eight hospitals participated in a pilot assessment of the level of fulfillment of each standard. A total of 37 standards were extracted. The Nominal Group produced additional standards, of which 60 were included in Questionnaire 0 that was used in the Delphi Technique. Two Delphi voting rounds were performed to reach a high level of consensus, and involved 64 and 62 participants with response rates of 90% and 87%, respectively. Finally, 39 standards for the management of cancer pain were agreed upon. In the self-evaluation, the average range of compliance was between 56.4% and 100%. The consensus standards of the ACDON Project might improve the monitoring of cancer pain management. These standards satisfied the demands of professionals and patients and could be used for the accreditation of approaches in cancer pain management. Full article
(This article belongs to the Special Issue Chronic Pain)
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10 pages, 348 KiB  
Article
Hormonal Contraceptive Treatment May Reduce the Risk of Fibromyalgia in Women with Dysmenorrhea: A Cohort Study
by Cheng-Hao Tu, Cheng-Li Lin, Su-Tso Yang, Wei-Chih Shen and Yi-Hung Chen
J. Pers. Med. 2020, 10(4), 280; https://doi.org/10.3390/jpm10040280 - 14 Dec 2020
Cited by 7 | Viewed by 2650
Abstract
Dysmenorrhea is the most common gynecological disorder for women in the reproductive age. Study has indicated that dysmenorrhea might be a general risk factor of chronic pelvic pain and even chronic non-pelvic pain, such as fibromyalgia. We used the Longitudinal Health Insurance Database [...] Read more.
Dysmenorrhea is the most common gynecological disorder for women in the reproductive age. Study has indicated that dysmenorrhea might be a general risk factor of chronic pelvic pain and even chronic non-pelvic pain, such as fibromyalgia. We used the Longitudinal Health Insurance Database 2000 from the Taiwan National Health Research Institutes Database to investigate whether women with dysmenorrhea have a higher risk of fibromyalgia and whether treatment of dysmenorrhea reduced the risk of fibromyalgia. The dysmenorrhea cohort was matched with a non-dysmenorrhea cohort at a 1:1 ratio based on gender, age, and the year of entry study by frequency matching. Multivariable Cox proportional hazard regression models were used to assess the risk of fibromyalgia, with controlling for potential confounding variables such as age, comorbidities, and medication use. After controlling confounding variables, results revealed that women with dysmenorrhea have a significantly higher risk of fibromyalgia than women without dysmenorrhea. However, only treatment of dysmenorrhea with hormonal contraceptives reduce the risk of fibromyalgia. These results indicated that dysmenorrhea may be a risk factor of fibromyalgia, whereas personalized medicine for treatment of dysmenorrhea may be the key to reduce the risk of fibromyalgia. Future studies are needed to identify the causes and prevention strategies in detail. Full article
(This article belongs to the Special Issue Chronic Pain)
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24 pages, 2805 KiB  
Article
Altered Interoceptive Perception and the Effects of Interoceptive Analgesia in Musculoskeletal, Primary, and Neuropathic Chronic Pain Conditions
by Daniele Di Lernia, Marco Lacerenza, Vivien Ainley and Giuseppe Riva
J. Pers. Med. 2020, 10(4), 201; https://doi.org/10.3390/jpm10040201 - 29 Oct 2020
Cited by 39 | Viewed by 4850
Abstract
Chronic pain (CP) severely disrupts the daily life of millions. Interoception (i.e., sensing the physiological condition of the body) plays a pivotal role in the aetiology and maintenance of CP. As pain is inherently an interoceptive signal, interoceptive frameworks provide important, but underutilized, [...] Read more.
Chronic pain (CP) severely disrupts the daily life of millions. Interoception (i.e., sensing the physiological condition of the body) plays a pivotal role in the aetiology and maintenance of CP. As pain is inherently an interoceptive signal, interoceptive frameworks provide important, but underutilized, approaches to this condition. Here we first investigated three facets of interoceptive perception in CP, compared with pain-free controls. We then introduce a novel interoceptive treatment and demonstrate its capacity to reduce pain severity in CP, potentially providing complementary analgesic treatments. Study 1 measured interoceptive accuracy, confidence and sensibility in patients (N = 60) with primary, secondary musculoskeletal, and neuropathic CP. Compared with matched controls, CP participants exhibited significantly lower interoceptive accuracy and interoceptive confidence. Pain severity was predicted positively by interoceptive accuracy, anxiety and depression, and negatively by interoceptive confidence. Study 2 tested a promising new interoceptive treatment for CP, in a single-blind between-subjects design (N = 51) with primary, secondary musculoskeletal, and neuropathic CP patients. The treatment specifically activates the C-Tactile system, by means of controlled stimulation of interoceptive unmyelinated afferents, at 3 cm/s with a force of 2.5 mN. This treatment led to significant pain reduction (mean 23%) in the CP treatment group after only 11 min, while CP controls who received comparable but non-interoceptive stimulation reported no change in pain intensity. These studies highlight the importance of interoceptive approaches to CP and demonstrate the potential of this novel method of C-Tactile stimulation to provide complementary analgesic treatments. Full article
(This article belongs to the Special Issue Chronic Pain)
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9 pages, 1002 KiB  
Article
Opioid Induced Hyperalgesia, a Research Phenomenon or a Clinical Reality? Results of a Canadian Survey
by Grisell Vargas-Schaffer, Suzie Paquet, Andrée Neron and Jennifer Cogan
J. Pers. Med. 2020, 10(2), 27; https://doi.org/10.3390/jpm10020027 - 21 Apr 2020
Cited by 15 | Viewed by 7638
Abstract
Background: Very little is known regarding the prevalence of opioid induced hyperalgesia (OIH) in day to day medical practice. The aim of this study was to evaluate the physician’s perception of the prevalence of OIH within their practice, and to assess the level [...] Read more.
Background: Very little is known regarding the prevalence of opioid induced hyperalgesia (OIH) in day to day medical practice. The aim of this study was to evaluate the physician’s perception of the prevalence of OIH within their practice, and to assess the level of physician’s knowledge with respect to the identification and treatment of this problem. Methods: An electronic questionnaire was distributed to physicians who work in anesthesiology, chronic pain, and/or palliative care in Canada. Results: Of the 462 responses received, most were from male (69%) anesthesiologists (89.6%), in the age range of 36 to 64 years old (79.8%). In this study, the suspected prevalence of OIH using the average number of patients treated per year with opioids was 0.002% per patient per physician practice year for acute pain, and 0.01% per patient per physician practice year for chronic pain. Most physicians (70.2%) did not use clinical tests to help make a diagnosis of OIH. The treatment modalities most frequently used were the addition of an NMDA antagonist, combined with lowering the opioid doses and using opioid rotation. Conclusions: The perceived prevalence of OIH in clinical practice is a relatively rare phenomenon. Furthermore, more than half of physicians did not use a clinical test to confirm the diagnosis of OIH. The two main treatment modalities used were NMDA antagonists and opioid rotation. The criteria for the diagnosis of OIH still need to be accurately defined. Full article
(This article belongs to the Special Issue Chronic Pain)
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