Transition from acute to chronic postsurgical pain: risk factors and protective factors
Joel Katz,Ze'ev Seltzer +1 more
TLDR
It is argued that a focus on the transition from acute to chronic pain may reveal important cues that will help to predict who will go on to develop chronic pain and who will not and how to identify the risk factors and protective factors that predict the course of recovery.Abstract:
Most patients who undergo surgery recover uneventfully and resume their normal daily activities within weeks. Nevertheless, chronic postsurgical pain develops in an alarming proportion of patients. The prevailing approach of focusing on established chronic pain implicitly assumes that information generated during the acute injury phase is not important to the subsequent development of chronic pain. However, a rarely appreciated fact is that every chronic pain was once acute. Here, we argue that a focus on the transition from acute to chronic pain may reveal important cues that will help us to predict who will go on to develop chronic pain and who will not. Unlike other injuries, surgery presents a unique set of circumstances in which the precise timing of the physical insult and ensuing pain are known in advance. This provides an opportunity, before surgery, to identify the risk factors and protective factors that predict the course of recovery. In this paper, the epidemiology of chronic postsurgical pain...read more
Citations
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References
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Sensory afferent impulses originate from dorsal root ganglia as well as from the periphery in normal and nerve injured rats
Patrick D. Wall,Marshall Devor +1 more
TL;DR: The dorsal root ganglion with its ongoing activity and mechanical sensitivity could be a source of pain producing impulses and could particularly contribute to pain in those conditions of peripheral nerve damage where pain persists after peripheral anaesthesia or where vertebral manipulation is painful.
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Chronic pain after surgery
TL;DR: Predictive factors are reviewed and core risk factor and outcome domains for inclusion in future epidemiological studies investigating chronic pain after surgery are proposed to advance the field of CPSP research by striving for consensus among pain experts.