Preventing chronic pain following acute pain: risk factors, preventive strategies, and their efficacy.
When pain persists beyond the expected timeframe for resolution and recovery from tissue injury, this constitutes the bridge from acute to chronic pain. Some of the studied models for prevention of chronic pain following acute pain include post-surgical pain, persistent post-traumatical pain, and post-herpetic neuralgia. This article reviewed current evidence in pathophysiology, epidemiology, risk factors, and treatment strategies for the prevention of chronic pain, using these models.
Clinically relevant recommendations given in this review were:
- Optimise analgesia in the acute injury and preoperative phases with extension into the post-operative/ healing period;
- Screen patients for the presence of major depression and other psychiatric conditions that may impact analgesic strategies;
- Identify patient risk factors for the development of chronic pain, and manage accordingly;
- Identify patients who have suboptimal responses during acute and subacute phase and are likely to develop chronic pain: interdisciplinary pain management can be initiated.
Overall, treating acute and chronic pain might not only be an issue of what treatment strategies to use, but rather how and when to start. Further research should cover these issues > From: McGreevy et al., Eur J Pain Suppl. 5 (2011) 365-372. All rights reserved to the European Federation of IASP Chapters. Published by Elsevier Ltd.
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