Pain is according to the widely accepted IASP definition “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. Acute pain has a protective function, but persistent pain is often complex in its nature and is no longer meaningful for the individual.
In rheumatology pain is often nociceptive, and associated to inflammation and tissue damage. Neuropathic pain, as a result of direct injury of the nerves, is also often possible to relate to an obvious cause. When pain becomes longstanding some people develop a dysfunction in the nociceptive system, with phenomenon such as central sensitization and loss of central inhibition of pain signals. In these cases pain becomes a disease in its own, complicating the clinical picture and demands other considerations in management than nociceptive and neuropathic pain.
The lecture will briefly present the neurophysiology behind pain and also the more complex mechanisms when pain becomes longstanding, leading to suggestions on how to treat pain on a mechanism based approach. This will include both phamacological and non-pharmacological management.
Disclosure of Interest None declared