Kronik Ağrı Sendromları
Özet
Kronik ağrı, dünya genelinde milyonlarca insanı etkileyen yaygın bir sağlık sorunudur. Kronik ağrı, genellikle altı aydan uzun süren ve bireylerin yaşam kalitesini ciddi şekilde etkileyen ağrı durumlarıdır. Bu tür ağrı hem biyolojik hem de psikososyal bileşenlere sahiptir ve tedavisi oldukça karmaşıktır. Kronik ağrı sendromları, modern tıbbın en karmaşık ve zorlayıcı sorunlarından biridir. Kronik ağrı sendromunda fizyolojik ve fonksiyonel değerlendirme ve detaylı fizik muayene yapılması gerekir. Hastaya iyi bir değerlendirme ve uygun konsültasyon kararı vermek için ayrıntılı bir anamnez alınması gereklidir. Ayrıntılı bir şekilde kas iskelet sistemi, üreme, gastrointestinal, ürolojik ve nöropsikiyatrik sistemin değerlendirilmesi yapılmalıdır. Tıbbi tedaviye genellikle tam cevap vermeyen kronik ağrı sendromu en iyi multidisipliner yaklaşımla tedavi edilebilir. Tedavideki amaç gerçekçi ve normal fonksiyonun restorasyonunu hedefleyen bir yaklaşım olmalıdır. Bu yazıda, kronik ağrının tanımı, türleri, sebepleri, belirtileri, teşhisi, tedavi yöntemleri ve yaşam tarzı değişiklikleri gibi konuları ayrıntılı bir şekilde ele alacağız.
Referanslar
IASP Subcommittee on Taxonomy. Classification of chronic pain: description of chronic pain syndromes and definition of pain terms. Pain. 1986;3:1-226.
Turk DC, Okifuji A. Pain terms and taxonomies of pain. In: Loeser JD, ed. Bonica’s Management of Pain. Philadelphia: Lippincott Williams & Wilkins; 2001:17-25.
Jacobsen L, Mariano AJ. General considerations of chronic pain. In: Loeser JD, ed. Bonica’s Management of Pain. Philadelphia: Lippincott Williams & Wilkins; 2001:241-254.
Bonica JJ, Loeser JD. History of pain concepts and therapies. In: Loeser JD, ed. Bonica’s Management of Pain. Philadelphia: Lippincott Williams & Wilkins; 2001:3-16.
Crook J, Rideout E, Browne G. The prevalence of pain complaints in a general population. Pain. 1984;18:299-314.
Podichetty VK, Mazanec DJ, Biscup RS. Chronic non-malignant musculoskeletal pain in older adults: clinical issues and opioid intervention. Postgrad Med J. 2003;79:627-633.
Gureje O, Von Korff M, Simon GE, Gater R. Persistent pain and wellbeing: a World Health Organization study in primary care. JAMA. 1998;280:147-151.
Bloodworth D, Cavillo O, Smith K, Grabois M. Chronic pain syndromes: evaluation and treatment. In: Braddom RL, ed. Physical Medicine and Rehabilitation. Philadelphia: WB Saunders Company; 2000:913-933.
Gerdle B, Björk J, Henriksson C, Bengtsson A. Prevalence of current and chronic pain and their influences upon work and healthcare-seeking: a population study. J Rheumatol. 2004;31(7):1399-1406.
Bloodworth D, Cavillo O, Smith K, Grabois M. Chronic pain syndromes: evaluation and treatment. In: Braddom RL, ed. Physical Medicine and Rehabilitation. Philadelphia: WB Saunders Company; 2000:913-933.
Duarte RA. Classification of pain. In: Kanner R, ed. Pain Management Secrets. Philadelphia: Hanley & Belfus; 1997:5-7.
IASP Subcommittee on Taxonomy. Classification of chronic pain: description of chronic pain syndromes and definition of pain terms. Pain. 1986;Suppl 3:1-226.
Turk DC, Okifuji A. Pain terms and taxonomies of pain. In: Loeser JD, ed. Bonica’s Management of Pain. Philadelphia: Lippincott Williams & Wilkins; 2001:17-25.
Fishbain DA, Cole B, Lewis JE, Gao J. Does pain interfere with antidepressant depression treatment response and remission in patients with depression and pain? An evidence-based structured review. Pain Med. 2014;15:1522.
Gatchel RJ, McGeary DD, McGeary CA, Lippe B. Interdisciplinary chronic pain management: past, present, and future. Am Psychol. 2014;69:119.
Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil. 2011;92:2041.
Kosek E, Cohen M, Baron R, et al. Do we need a third mechanistic descriptor for chronic pain states? Pain. 2016;157:1382.
Treede RD, Rief W, Barke A, et al. Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the International Classification of Diseases (ICD-11). Pain. 2019;160:19.
Dimcevski G, Sami SA, Funch-Jensen P, et al. Pain in chronic pancreatitis: the role of reorganization in the central nervous system. Gastroenterology. 2007;132:1546.
Steege JF, Siedhoff MT. Chronic pelvic pain. Obstet Gynecol. 2014;124:616.
Lai HH, Gardner V, Ness TJ, Gereau RW 4th. Segmental hyperalgesia to mechanical stimulus in interstitial cystitis/bladder pain syndrome: evidence of central sensitization. J Urol. 2014;191:1294.
Carroll CP, Lanzkron S, Haywood C Jr, et al. Chronic opioid therapy and central sensitization in sickle cell disease. Am J Prev Med. 2016;51
Goldenberg DL. Overview of chronic widespread (centralized) pain in the rheumatic diseases. Rheumatology.
Bloodworth D, Cavillo O, Smith K, Grabois M. Chronic pain syndromes: evaluation and treatment. In: Braddom RL, ed. Physical Medicine and Rehabilitation. Philadelphia: WB Saunders Company; 2000:913-933.
Patil JJP. Chronic pain syndromes. In: O’Young B, Young MA, Stiens SA, eds. PM&R Secrets. Philadelphia: Hanley & Belfus; 1997:351-355.
Siqveland J, Ruud T, Hauff E. Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain. Eur J Psychotraumatol. 2017;8:1375337.
McWilliams LA, Cox BJ, Enns MW. Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain. 2003;106:127.
Fishbain DA, Cole B, Lewis JE, Gao J. Does pain interfere with antidepressant depression treatment response and remission in patients with depression and pain? An evidence-based structured review. Pain Med. 2014;15:1522.
Tang NK, Crane C. Suicidality in chronic pain: a review of the prevalence, risk factors, and psychological links. Psychol Med. 2006;36:575.
Siqveland J, Ruud T, Hauff E. Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain. Eur J Psychotraumatol. 2017;8:1375337.
Turk DC. Cognitive-behavioral approach to the treatment of chronic pain patients. Reg Anesth Pain Med. 2003;28:573-579.
Turk DC, Okifuji A. Assessment of patients' reporting of pain: an integrated perspective. Lancet. 1999;353:1784-1788.
LeResche L. Gender, cultural and environmental aspects of pain. In: Loeser JD, ed. Bonica’s Management of Pain. Philadelphia, PA: Lippincott Williams & Wilkins; 2001:191-195.
Green CR, Anderson KO, Baker TA, et al. The unequal burden of pain: confronting racial and ethnic disparities in pain. Pain Med. 2003;4(3):277-294.
American College of Rheumatology Pain Management Task Force. Report of the American College of Rheumatology Pain Management Task Force. Arthritis Care Res (Hoboken). 2010;62:590.
Borenstein DG, Hassett AL, Pisetsky D. Pain management in rheumatology research, training, and practice. Clin Exp Rheumatol. 2017;35 Suppl 107:2.
Galer BS, Jensen MP. Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale. Neurology. 1997;48:332.
Hergenroeder AC, Bachur RG. Approach to chronic knee pain or injury in children or skeletally immature adolescents. UpToDate. 2021.
Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14:1539.
Shaughnessy AF. CBT effective for chronic insomnia. Am Fam Physician. 2016;93:60.
Petrosky E, Harpaz R, Fowler KA, et al. Chronic pain among suicide decedents, 2003 to 2014: findings from the National Violent Death Reporting System. Ann Intern Med. 2018;169:448.
Rose AR, Catcheside PG, McEvoy RD, et al. Sleep disordered breathing and chronic respiratory failure in patients with chronic pain on long term opioid therapy. J Clin Sleep Med. 2014;10:847.
Siqveland J, Ruud T, Hauff E. Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain. Eur J Psychotraumatol. 2017;8:1375337.
Tauben D, Stacey BR. Pharmacologic management of chronic non-cancer pain in adults. UpToDate. 2020.
Aminoshariae A, Khan A. Acetaminophen: old drug, new issues. J Endod. 2015;41:588.
Bravo L, Llorca-Torralba M, Berrocoso E, Micó JA. Monoamines as drug targets in chronic pain: focusing on neuropathic pain. Front Neurosci. 2019;13:1268.
Cooper TE, Fisher E, Gray AL, et al. Opioids for chronic non-cancer pain in children and adolescents. Cochrane Database Syst Rev. 2017;7
Stahl SM, Porreca F, Taylor CP, et al. The diverse therapeutic actions of pregabalin: is a single mechanism responsible for several pharmacological activities? Trends Pharmacol Sci. 2013;34:332.
Skelly AC, Chou R, Dettori JR, et al. Noninvasive nonpharmacological treatment for chronic pain: a systematic review. Agency for Healthcare Research and Quality (US). 2018.
Wertli MM, Rasmussen-Barr E, Held U, et al. Fear-avoidance beliefs: a moderator of treatment efficacy in patients with low back pain: a systematic review. Spine J. 2014;14:2658.
Debar LL, Kindler L, Keefe FJ, et al. A primary care-based interdisciplinary team approach to the treatment of chronic pain utilizing a pragmatic clinical trials framework. Transl Behav Med. 2012;2:523.
