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Nonnarcotic Methods of Pain Management
Open accessAbstract
Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or [is] described in terms of uch dama e” when there is no h sical deran ement 1 The function of ain is to protect the body by making the organism aware of damaging events and to promote healing by causing sensitivity to movement or other stimuli that may delay recovery. However, pain is not always related to tissue damage and does not always serve a protective function. This is the case with neuropathic pain, which is caused by a lesion or disease of the somatosensory parts of the nervous system, and with some other chronic pain conditions, such as fibromyalgia and migraine.2 Acute and chronic pain may cause suffering and interfere with daily life, factors that influence the choice of treatment. Acute pain is the most common reason for visiting an emergency department,3 and surgical procedures are often associated with acute postoperative pain.4,5 Chronic pain also causes suffering, as reflected by the finding in the Global Burden of Disease Study 2013 that chronic low back pain was the leading cause of years lived with disability.6 In addition to the contribution of pain to disability, that study showed that the associated problem of opioid use disorders accounted for 5.8 million additional years lived with disability,6 an observation that underpins attempts to treat pain with drugs other than opioids. Long-term opioid administration has minimal effects on chronic pain and can cause tolerance, drowsiness, and dependence, as well as impaired memory, concentration, and judgment.7 For these reasons, the International Association for the Study of Pain recommends caution in prescribing opioids for chronic pain,8 and there has been an increased emphasis on the use of nonopioid pain management. The choice of treatment for pain depends on many factors, and the heterogeneity and large number of acute and chronic pain conditions preclude a general treatment algorithm. In cooperation with the World Health Organization, the International Association for the Study of Pain has developed a classification of chronic pain for the 11th revision of the International Classification of Diseases2 (Table 1), and a similar classification has been proposed for acute pain,5 providing the bases for facilitating treatment pathways.
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“Non-specific chronic low back pain (NCLBP), defined as pain lasting for 12 weeks or longer [4], can cause not only physical suffering, but also psychological and social problems [5].”
From Effect of m-health-based core stability exercise combined with self-compassion training for patients with non-specific chronic low back pain: study protocol for a randomized controlled trial (2022) · cites this paper as [5]
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Metadata
- Authors
- Finnerup, N. B.
- Affiliations
- Aarhus University (DK)
- Corresponding author
- Finnerup, Nanna B.
- ORCID
- Finnerup, Nanna B.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2019-06-20
- Volume
- 380
- Issue
- 25
- Pages
- 2440-2448
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2952209165
- Cited by
- 153
- References
- 45
- Citations by year
- 2026: 21 · 2025: 18 · 2024: 18 · 2023: 24 · 2022: 20 · 2021: 34 · 2020: 16 · 2019: 2
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Keywords
- chronic pain, acute pain, neuropathic pain, fibromyalgia, migraine, opioid use disorder, opioid tolerance and dependence, postoperative pain, chronic low back pain, pain classification, International Association for the Study of Pain
- MeSH terms
- Complementary Therapies, Anticonvulsants, Antidepressive Agents, Humans, Pain, Pain Measurement, Patient Education as Topic, Psychotherapy, Analgesics, Non-Narcotic, Pain Management
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