Classification of pain

Dallel, R. and Voisin, D. Towards pain treatment based on the classification of pain-generating mechanisms , Eur. Neurol. 2001, 45, 126-132. 

One classification of pain is to consider it as either acute or chronic. Since it is now recognized that the etiologies, pathophysiologies, functions, diagnoses, and therefore means of treatment for these two types of pain differ, it is useful to view them on this basis. 

There are six classifications of pain acute pain, chroiuc pain, visceral pain, somatic pain, neuropathic pain, and psychogenic pain. Pain can be treated non-pharmacologically or pharmacologically. 

Silberstein SD, Lipton RB, Dalessio DJ. Overview, diagnosis, and classification of headache. In Silberstein SD, Lipton RB, Dalessio DJ, eds. Wolff s Headache and Other Head Pain. 7th ed. New York Oxford University Press, 2001 6-26. 

Criteria for the classification of OA of the hips, knees, and hands were developed by the American College of Rheumatology (ACR). The criteria include the presence of pain, bony changes on examination, a normal erythrocyte sedimentation rate (ESR), and radiographs showing characteristic osteophytes or joint space narrowing. 

In addition to the target- and substance-orientated chapters, this chapter presents additional strategies for pain relief along with the classification of different strategies within a hypothetical time schedule. 

The Headache Classification Committee of the International Headache Society (1988) has developed diagnostic criteria for classification of headache disorders, cranial neuralgias, and facial pain the criteria include painful and nonpainful disorders of the entire head and are based on the diagnosis rather than on the underlying pain mechanisms. 

Braunwald s clinical classification of chest pain refines the discomforts of unstable angina (7), The severity of the chest pain is divided into three classes ... 

Many of the pain relievers described in this book are currently classified into these schedules, as listed in the table below. However, scheduling of individual drugs can change over time as trends in abuse potential and addiction to a particular drug change. Thus, the classification of drugs is continuously updated by the Drug Enforcement Administration (DEA). 

The subjective symptoms were arbitrarily classified somewhat along the classification of Thorp 19) as symptomatic, irritant, and severe irritant. Symptoms are named symptomatic when the subject experiences the first sensations, such as irritation of the throat and tickling in the nose. When the symptoms become permanent and unpleasant, they are named irritant, as well as when occasional coughing is observed. The symptoms are labeled severe irritant when coughing is produced by deep inspiration, pressure or pain in the chest appears, breathing becomes laborious and more frequent, and a constant sharp pain in the throat is felt. 

Delta Receptors. There has been considerable interest in 6 opioid agonists because they exhibit antinociceptive effects without the side effects associated with p, opioid receptor agonists. Antinociceptive activity was first demonstrated with 6-selective opioid peptides (see Ref 218 for a review), and more recently with nonpeptidic 6-selective agonists (see Refs. 219-222 for reviews). Of particular interest is the activity of 6 agonists in inflammatory and neuropathic pain (220). Delta opioid receptors also modulate fx opioid receptors and, as discussed earlier, one classification of 6 opioid receptor subtypes was based on their association with p, opioid receptors. There is now considerable evidence that interaction between the two receptor types can alter the activity of p. opioid agonists. Delta agonists... 

The information given in this book may help to perform the best diagnosis in patients with acute thoracic pain and to take decisions, sometimes in an urgent manner, for the best approach of management in patients with acute and chronic IHDs. We would like to emphasise that we are not the editors, but the authors of the book. This is important, because all the information is given in a homogeneous manner, without the presence of contradictory opinions that often appear in edited books. Also, the presence of frequent cross-references within the text makes the content of the book easier to follow. We are aware that we are often repetitive, especially when we comment on the new concepts of ACS with or without STE and the new classification of Q-wave MI based on CMR correlations. However, we consider that this may be helpful especially for the readers who are not too much involved in the topic and also for consultants of some specific topic. 

Most clinicians consider the use of opioids to be the next logical step in the management of acute pain. The classification of these agents, their equianalgesic doses, and dosing guidelines are outlined in Tables 58-7 and 58-8. 

IASP Task Force on Taxonomy. In Classification of Chronic Pain, Merskey, H. Bogduk, N., Ed IASP Press Seattle, 1994 Second edition 209-214. 

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