Chronic Pain: Evolution of Clinical Definitions and Implications for Practice
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Chronic Pain: Evolution of Clinical Definitions and Implications for Practice Angela Mailis1,2 · Perry S. Tepperman3,4 · Eleni G. Hapidou5,6,7 Received: 24 August 2020 / Accepted: 12 October 2020 / Published online: 1 December 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Numerous definitions of pain have been proposed over many years with different implications when applied to clinical practice. This paper reviews information regarding the evolution of definitions of pain terminology and pain syndromes as they relate to everyday practice for clinicians and those operating within the medicolegal judicial system, both trainees and seasoned professionals, with a focus on chronic pain. An historical overview of the evolution and chronology of chronic pain labels and definitions is provided with emphasis on those used currently in clinical practice. Subsequently, the paper mainly concentrates on the two more recent revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA) and the basic principles of International Classification of Diseases (ICD) by the World Health Organization (WHO). It further provides a summary of the newly accepted WHO ICD-11 novel classification of pain disorders, a joint effort of WHO and the International Association for the Study of Pain (IASP). We conclude our review by providing our personal opinions and commentaries on controversies and dilemmas associated with the DSM, and ICD pain definitions and classifications, and offer useful tips for those who perform forensic examinations. Keywords Chronic pain · Musculoskeletal · Neuropathic · Nociceptive · Nociplastic
Introduction
* Angela Mailis [email protected]; [email protected] Perry S. Tepperman [email protected] Eleni G. Hapidou [email protected] 1
Pain and Wellness Centre, 2301 Major Mackenzie Dr. West, Unit #101, ON, Vaughan, Canada
2
Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, ON, Toronto, Canada
3
Physical Medicine Clinic, ON, Thornhill, Canada
4
Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
5
Michael G. DeGroote Pain Clinic, ON, Hamilton, Canada
6
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
7
Department of Psychology, Neuroscience, and Behaviour, McMaster University, ON, Hamilton, Canada
In Canada, 20% of adults have reported experiencing chronic pain, and as the ageing population is growing, so is the magnitude of this major health problem (Hadi, McHugh, & Closs, 2018; Hurwitz et al., 2018). Globally, chronic pain is the fourth leading cause of disability-adjusted life years, according to the 2015 Global Burden of Disease Report (Vos et al., 2015). According to a recent study on the global, regional and national incidence, prevalence and years lived with disability for 301 acute and chronic diseases, seven of the most prevalent diso
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