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Cited by 170Pain Management and Opioid UsePain Mechanisms and TreatmentsAnesthesia and Pain Management

The DOI matches its Crossref record; 88 of the 88 references it cites were found in a registry or an index.

Pharmacological treatment of chronic pain—The need for CHANGE

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Varrassi, G., Müller-Schwefe, G., Pergolizzi, J., Orónska, A., Morlion, B., Mavrocordatos, P., Margarit, C., Mangas, C., Jaksch, W., Huygen, F., Collett, B., Berti, M., Aldington, D., Ahlbeck, K.·2010·Current Medical Research and Opinion
DOI 10.1185/03007991003689175
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Abstract

BACKGROUND: Although chronic pain affects around 20% of adults in Europe and the USA, there is substantial evidence that it is inadequately treated. In June 2009, an international group of pain specialists met in Brussels to identify the reasons for this and to achieve consensus on strategies for improving pain management. SCOPE: Literature on chronic pain management was reviewed, and information presented to and discussed by a panel of experts. FINDINGS: It was agreed that guidelines are not universally accepted by those involved in pain management, and pain treatment seems to be driven mainly by tradition and personal experience. Other factors include poor communication between patients and physicians, the side effects of analgesic drugs, and limited individualisation of therapy. Difficulty in maintaining the balance between adequate pain relief and acceptable tolerability, particularly with strong opioids, can lead to the establishment of a 'vicious circle' that alternates between lack of efficacy and unpleasant side effects, prompting discontinuation of treatment. The medical community's understanding of the physiological differences between nociceptive pain and neuropathic pain, which is often more severe and difficult to treat, could be improved. Increasing physicians' knowledge of the pharmacological options available to manage these different pain mechanisms offers the promise of better treatment decisions and more widespread adoption of a multi-mechanistic approach; this could involve loosely combining two substances from different drug classes, or administering an analgesic with two different mechanisms of action. In some circumstances, a single compound capable of addressing both nociceptive and neuropathic pain is desirable. CONCLUSIONS: To improve patient outcomes, a thorough understanding of pain mechanisms, sensitisation and multi-mechanistic management is required. Universal, user-friendly educational tools are therefore required to familiarise physicians with these topics, and also to improve communication between physicians and their pain patients, so that realistic expectations of treatment can be established.

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Research works printed but not linked: 3

  1. Coda BA Bonica JJ. General considerations of acute pain. In: Loeser JD Butler SH Chapman CR Turk DC eds. Bonica’s Management of Pain 3rd edn. Philadelphia PA: Lippincott Williams & Wilkins 2001:222-40
  2. Rodriguez MJ. Survey of therapeutic attitudes towards patients with chronic pain in Spanish Pain Units. Rev Soc Esp Dolor 2006;13:525-32
  3. Workers’ Compensation Report. Kew Victoria: Journal of Risk and Insurance 1 November 2004

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Metadata

Authors
Varrassi, G., Müller-Schwefe, G., Pergolizzi, J., Orónska, A., Morlion, B., Mavrocordatos, P., Margarit, C., Mangas, C., Jaksch, W., Huygen, F., Collett, B., Berti, M., Aldington, D., & Ahlbeck, K.
Affiliations
  • University of L'Aquila (IT)
  • Schmerz- und Palliativzentrum, Göppingen, Germany
  • Naples Anesthesia & Physician Associates (US)
  • Hospicjum Domowe, Wrocław, Poland
  • Universitair Ziekenhuis Leuven (BE)
  • Hirslanden Clinique Cecil (CH)
  • Hospital General Universitario de Alicante Doctor Balmis (ES)
  • Hospital de Santo André (PT)
  • Wilhelminen Hospital (AT)
  • Erasmus MC (NL)
  • Leicester Royal Infirmary (GB)
  • Ospedale di Parma (IT)
  • Churchill Hospital (GB)
  • Karolinska University Hospital (SE)
Corresponding author
Pergolizzi, J.
ORCID
Venue
Current Medical Research and Opinion
Publisher
Informa UK Limited
Published
2010-03-25
Volume
26
Issue
5
Pages
1231-1245
ISSN
  • 0300-7995 (ISSN-L)
  • 1473-4877
DOI
10.1185/03007991003689175
OpenAlex
W2003872067
Cited by
167
References
88
Citations by year
2026: 5 · 2025: 8 · 2024: 7 · 2023: 14 · 2022: 3 · 2021: 15 · 2020: 12 · 2019: 13 · 2018: 10 · 2017: 6 · 2016: 2 · 2015: 12 · 2014: 8 · 2013: 12 · 2012: 12
FWCI
3.27
Type
journal article
Language
en
Open access
Locations
  • Current Medical Research and Opinion (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
Keywords
chronic pain, pharmacotherapy, pain management, analgesic side effects, strong opioids, opioid tolerability, neuropathic pain, nociceptive pain, analgesic combination therapy, pain mechanisms, sensitization, physician-patient communication, treatment guidelines, physician training
MeSH terms
Analgesics, Chronic Disease, Humans, Pain, Practice Guidelines as Topic

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