Skip to main content

Advertisement

SpringerLink
Log in

An overview of treatment approaches for chronic pain management

  • Review Therapy
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Pain which persists after healing is expected to have taken place, or which exists in the absence of tissue damage, is termed chronic pain. By definition chronic pain cannot be treated and cured in the conventional biomedical sense; rather, the patient who is suffering from the pain must be given the tools with which their long-term pain can be managed to an acceptable level. This article will provide an overview of treatment approaches available for the management of persistent non-malignant pain. As well as attempting to provide relief from the physical aspects of pain through the judicious use of analgesics, interventions, stimulations, and irritations, it is important to pay equal attention to the psychosocial complaints which almost always accompany long-term pain. The pain clinic offers a biopsychosocial approach to treatment with the multidisciplinary pain management programme; encouraging patients to take control of their pain problem and lead a fulfilling life in spite of the pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

(adapted from [9], p. 94)

Similar content being viewed by others

References

  1. Turk D, Melzack R (2011) The measurement of pain and the assessment of people experiencing pain. In: Turk D, Melzack R (eds) Handbook of pain assessment, 3rd edn. Guilford Press, New York, p 542

    Google Scholar 

  2. International Association for the Study of Pain (1986) Classification of chronic pain: introduction. Pain 24:S3–S8. doi:10.1016/0304-3959(86)90107-7

    Article  Google Scholar 

  3. Melzack R, Wall PD (1996) The challenge of pain, 2nd edn. Penguin, London

    Google Scholar 

  4. Bandura A (1978) The self system in reciprocal determinism. Am Psychol 33:344–358. doi:10.1037/0003-066X.33.4.344

    Article  Google Scholar 

  5. Engel G (1977) The need for a new medical model: a challenge for biomedicine. Science 196:129–136

    Article  CAS  PubMed  Google Scholar 

  6. Jacobson L, Mariano A (2001) General considerations of chronic pain. In: Loeser J (ed) Bonica’s management of pain, 3rd edn. Lippincott, Williams & Wilkins, Philadelphia, pp 241–254

    Google Scholar 

  7. Loeser J (1991) The role of chronic pain clinics in managing back pain. In: Frymoyer J (ed) Adult spine Princ. Pract. Raven Press, New York, pp 221–229

    Google Scholar 

  8. Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD (2011) Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatol Int 31:1409–1417. doi:10.1007/s00296-011-1999-3

    Article  PubMed  Google Scholar 

  9. Ventafridda V, Saita L, Ripamonti C, De Conno F (1985) WHO guidelines for the use of analgesics in cancer pain. Int J Tissue React 7:93–96

    CAS  PubMed  Google Scholar 

  10. WHO (2013) WHO’s cancer pain ladder for adults. http://www.who.int/cancer/palliative/painladder/en/. Accessed 30 Nov 2015

  11. Kalso E, Edwards JE, Moore RA, McQuay HJ (2004) Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain 112:372–380. doi:10.1016/j.pain.2004.09.019

    Article  CAS  PubMed  Google Scholar 

  12. Rang H, Dale M, Ritter J, Flower R, Henderson G (2012) Rang & Dale’s Pharmacology, 7th edn. Elsevier, London

    Google Scholar 

  13. Vane JR, Bakhle YS, Botting RM (1998) Cyclooxygenases 1 and 2. Annu Rev Pharmacol Toxicol 38:97–120. doi:10.1146/annurev.pharmtox.38.1.97

    Article  CAS  PubMed  Google Scholar 

  14. Silverstein F, Faich G, Goldstein J (2000) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized. JAMA 284:1247–1255

    Article  CAS  PubMed  Google Scholar 

  15. Bombardier C, Laine L, Reicin A, Shapiro D, Burgos-Vargas R, Davis B, Day R, Ferraz MB, Hawkey CJ, Hochberg MC, Kvien TK (2000) Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med 343:1520–1528

    Article  CAS  PubMed  Google Scholar 

  16. Schnitzer TJ, Burmester GR, Mysler E, Hochberg MC, Doherty M, Ehrsam E, Gitton X, Krammer G, Mellein B, Matchaba P, Gimona A, Hawkey CJ (2004) Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), reduction in ulcer complications: randomised controlled trial. Lancet 364:665–674. doi:10.1016/S0140-6736(04)16893-1

    Article  CAS  PubMed  Google Scholar 

  17. Solomon SD, McMurray JJV, Pfeffer MA, Wittes J, Fowler R, Finn P, Anderson WF, Zauber A, Hawk E, Bertagnolli M (2005) Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention. N Engl J Med 352:1071–1080. doi:10.1056/NEJMoa050405

    Article  CAS  PubMed  Google Scholar 

  18. Bresalier RS, Sandler RS, Quan H, Bolognese JA, Oxenius B, Horgan K, Lines C, Riddell R, Morton D, Lanas A, Konstam MA, Baron JA (2005) Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med 352:1092–1102. doi:10.1056/NEJMoa050493

    Article  CAS  PubMed  Google Scholar 

  19. Mukherjee D, Nissen SE, Topol EJ (2001) Risk of cardiovascular events associated with selective COX-2 inhibitors. JAMA, J Am Med Assoc 286:954–959. doi:10.1001/jama.286.8.954

    Article  CAS  Google Scholar 

  20. Nussmeier NA, Whelton AA, Brown MT, Langford RM, Hoeft A, Parlow JL, Boyce SW, Verburg KM (2005) Complications of the COX-2 inhibitors parecoxib and valdecoxib after cardiac surgery. N Engl J Med 352:1081–1091. doi:10.1056/NEJMoa050330

    Article  CAS  PubMed  Google Scholar 

  21. Kerr DJ, Dunn JA, Langman MJ, Smith JL, Midgley RSJ, Stanley A, Stokes JC, Julier P, Iveson C, Duvvuri R, McConkey CC (2007) Rofecoxib and cardiovascular adverse events in adjuvant treatment of colorectal cancer. N Engl J Med 357:360–369. doi:10.1056/NEJMoa071841

    Article  CAS  PubMed  Google Scholar 

  22. Cullen L, Kelly L, Connor SO, Fitzgerald DJ (1998) Selective cyclooxygenase-2 inhibition by nimesulide in man. J Pharmacol Exp Ther 287:578–582

    CAS  PubMed  Google Scholar 

  23. McAdam BF, Catella-Lawson F, Mardini IA, Kapoor S, Lawson JA, FitzGerald GA (1999) Systemic biosynthesis of prostacyclin by cyclooxygenase (COX)-2: the human pharmacology of a selective inhibitor of COX-2. Proc Natl Acad Sci 96:272–277. doi:10.1073/pnas.96.1.272

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Zarraga IGE, Schwarz ER (2007) Coxibs and heart disease. What we have learned and what else we need to know. J Am Coll Cardiol 49:1–14. doi:10.1016/j.jacc.2006.10.003

    Article  CAS  PubMed  Google Scholar 

  25. Capone ML, Tacconelli S, Sciulli MG, Grana M, Ricciotti E, Minuz P, Di Gregorio P, Merciaro G, Patrono C, Patrignani P (2004) Clinical pharmacology of platelet, monocyte, and vascular cyclooxygenase inhibition by naproxen and low-dose aspirin in healthy subjects. Circulation 109:1468–1471. doi:10.1161/01.CIR.0000124715.27937.78

    Article  CAS  PubMed  Google Scholar 

  26. Hecken A, Schwartz JI, Depré M, Lepeleire I, Dallob A, Tanaka W, Wynants K, Buntinx A, Arnout J, Wong PH, Ebel DL (2000) Comparative inhibitory activity of rofecoxib, meloxicam, diclofenac, ibuprofen, and naproxen on COX2 versus COX1 in healthy volunteers. J Clin Pharmacol 40:1109–1120

    PubMed  Google Scholar 

  27. Kearney PM, Baigent C, Godwin J, Halls H, Emberson JR, Patrono C (2006) Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ 332:1302–1308. doi:10.1136/bmj.332.7553.1302

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. McGettigan P, Henry D (2006) Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of the observational studies of selective and nonselective inhibitors of cyclooxygenase 2. JAMA 296:1633–1644. doi:10.1001/jama.296.13.jrv60011

    Article  CAS  PubMed  Google Scholar 

  29. Ray WA, Varas-Lorenzo C, Chung CP, Castellsague J, Murray KT, Stein CM, Daugherty JR, Arbogast PG, García-Rodríguez LA (2009) Cardiovascular risks of nonsteroidal antiinflammatory drugs in patients after hospitalization for serious coronary heart disease. Circ Cardiovasc Qual Outcomes 2:155–163. doi:10.1161/CIRCOUTCOMES.108.805689

    Article  PubMed  Google Scholar 

  30. Bhala N, Emberson J, Merhi A, Abramson S, Arber N, Baron JA, Bombardier C, Cannon C, Farkouh ME, FitzGerald GA, Goss P, Halls H, Hawk E, Hawkey C, Hennekens C, Hochberg M, Holland LE, Kearney PM, Laine L, Lanas A, Lance P, Laupacis A, Oates J, Patrono C, Schnitzer TJ, Solomon S, Tugwell P, Wilson K, Wittes J, Baigent C (2013) Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet (London, England) 382:769–79. doi:10.1016/S0140-6736(13)60900-9

  31. European Medicines Agency (2005) Press Release: European Medicines Agency concludes action on COX-2 inhibitors. http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2010/01/WC500059088.pdf. Accessed 7 Mar 2016

  32. European Medicines Agency (2006) Press Release: European Medicines Agency review concludes positive benefit–risk balance for nonselective NSAIDs. http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2009/12/WC500017362.pdf. Accessed 7 Mar 2016

  33. Solomon DH, Rassen JA, Glynn RJ, Garneau K, Levin R, Lee J, Schneeweiss S (2010) The comparative safety of opioids for nonmalignant pain in older adults. Arch Intern Med 170:1979–1986. doi:10.1001/archinternmed.2010.450

    Article  PubMed  Google Scholar 

  34. Christie MJ (2008) Cellular neuroadaptations to chronic opioids: tolerance, withdrawal and addiction. Br J Pharmacol 154:384–396. doi:10.1038/bjp.2008.100

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Trescot AM, Helm S, Hansen H, Benyamin R, Glaser SE, Adlaka R, Patel S (2008) Opioids in the management of chronic non-cancer pain: an update of American Society of the Interventional Pain Physicians’ (ASIPP) Guidelines. Pain Phys 11:S5–S62

    Google Scholar 

  36. Ballantyne JC, Mao J (2003) Opioid therapy for chronic pain. N Engl J Med 349:1943–1953. doi:10.1056/NEJMra025411

    Article  CAS  PubMed  Google Scholar 

  37. Ngian G-S, Guymer EK, Littlejohn GO (2011) The use of opioids in fibromyalgia. Int J Rheum Dis 14:6–11. doi:10.1111/j.1756-185X.2010.01567.x

    Article  PubMed  Google Scholar 

  38. Goldenberg DL, Burckhardt C, Crofford L (2014) Manag Fibromyalgia Syndr 292:2388–2395

    Google Scholar 

  39. Harris RE, Clauw DJ, Scott DJ, McLean SA, Gracely RH, Zubieta J-K (2007) Decreased central–opioid receptor availability in fibromyalgia. J Neurosci 27:10000–10006. doi:10.1523/JNEUROSCI.2849-07.2007

    Article  CAS  PubMed  Google Scholar 

  40. Painter JT, Crofford LJ (2013) Chronic opioid use in fibromyalgia syndrome: a clinical review. J Clin Rheumatol 19:72–77. doi:10.1097/RHU.0b013e3182863447

    Article  PubMed  Google Scholar 

  41. Fitzcharles M, Ste-marie PA, Goldenberg DL, John X, Abbey S, Choinière M, Ko G, Moulin D, Panopalis P, Proulx J, Shir Y (2012) 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome. Pain Res Manag 18:1–52

    Google Scholar 

  42. Bernardy K, Klose P, Uçeyler N, Kopp I, Häuser W (2008) Methodological fundamentals for the development of the guideline. Schmerz 22:244–254. doi:10.1007/s00482-008-0670-8

    Article  CAS  PubMed  Google Scholar 

  43. Grape S, Schug SA, Lauer S, Schug BS (2010) Formulations of fentanyl for the management of pain. Drugs 70:57–72. doi:10.2165/11531740-000000000-00000

    Article  CAS  PubMed  Google Scholar 

  44. Pergolizzi J, Aloisi AM, Dahan A, Filitz J, Langford R, Likar R, Mercadante S, Morlion B, Raffa RB, Sabatowski R, Sacerdote P, Torres LM, Weinbroum AA (2010) Current Knowledge of Buprenorphine and Its Unique Pharmacological Profile. Pain Pract 10:428–450. doi:10.1111/j.1533-2500.2010.00378.x

    Article  PubMed  Google Scholar 

  45. Dworkin RH, O’Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice ASC, Stacey BR, Treede R-D, Turk DC, Wallace MS (2007) Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain 132:237–251. doi:10.1016/j.pain.2007.08.033

    Article  CAS  PubMed  Google Scholar 

  46. Campbell BJ, Rowbotham M, Davies PS, Jacob P, Benowitz NL (2002) Systemic absorption of topical lidocaine in normal volunteers, patients with post-herpetic neuralgia, and patients with acute herpes zoster. J Pharm Sci 91:1343–1350. doi:10.1002/jps.10133

    Article  CAS  PubMed  Google Scholar 

  47. Derry S, Wiffen P, Moore R, Quinlan J (2014) Topical lidocaine for neuropathic pain in adults (Review). Cochrane Database Syst Rev 7:1–50

    Google Scholar 

  48. Micó JA, Ardid D, Berrocoso E, Eschalier A (2006) Antidepressants and pain. Trends Pharmacol Sci 27:348–354. doi:10.1016/j.tips.2006.05.004

    Article  PubMed  CAS  Google Scholar 

  49. Arnold LM, Keck PEJ, Welge JA (2000) Antidepressant treatment of fibromyalgia. A meta-analysis and review. Psychosomatics 41:104–113

    Article  CAS  PubMed  Google Scholar 

  50. Häuser W, Walitt B, Fitzcharles M-A, Sommer C (2014) Review of pharmacological therapies in fibromyalgia syndrome. Arthritis Res Ther 16:201. doi:10.1186/ar4441

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  51. Watson CPN, Chipman ML, Monks RC (2006) Antidepressant analgesics: a systematic review and comparative study. In: McMahon S, Koltzenburg M (eds) Wall Melzack’s Textb. Pain, 5th edn. Elsevier, London, p 1280

    Google Scholar 

  52. Taylor CP, Angelotti T, Fauman E (2007) Pharmacology and mechanism of action of pregabalin: the calcium channel alpha2-delta subunit as a target for antiepileptic drug discovery. Epilepsy Res 73:137–150. doi:10.1016/j.eplepsyres.2006.09.008

    Article  CAS  PubMed  Google Scholar 

  53. Field MJ, Cox PJ, Stott E, Melrose H, Offord J, Su T-Z, Bramwell S, Corradini L, England S, Winks J, Kinloch RA, Hendrich J, Dolphin AC, Webb T, Williams D (2006) Identification of the alpha2-delta-1 subunit of voltage-dependent calcium channels as a molecular target for pain mediating the analgesic actions of pregabalin. Proc Natl Acad Sci USA 103:17537–17542. doi:10.1073/pnas.0409066103

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Crofford LJ, Mease PJ, Simpson SL, Young JP, Martin SA, Haig GM, Sharma U (2008) Fibromyalgia relapse evaluation and efficacy for durability of meaningful relief (FREEDOM): a 6-month, double-blind, placebo-controlled trial with pregabalin. Pain 136:419–431. doi:10.1016/j.pain.2008.02.027

    Article  CAS  PubMed  Google Scholar 

  55. Vargas-Schaffer G (2010) Is the WHO analgesic ladder still valid? Twenty-four years of experience. Can Fam Physician 56(514–7):e202–e205

    PubMed Central  Google Scholar 

  56. Pergolizzi BJV, Raffa RB (2014) The WHO pain ladder: do we need another step? Pract Pain Manag 14:1–17

    Google Scholar 

  57. Watts RW, Silagy CA (1995) A meta-analysis on the efficacy of epidural corticosteroids in the treatment of sciatica. Anaesth Intensive Care 23:564–569

    CAS  PubMed  Google Scholar 

  58. McQuay H, Moore R (1998) Epidural corticosteroids for sciatica. In: An evidence-based Resour. Pain Reli. Oxford University Press, Oxford, p 270

  59. Boswell MV, Colson JD, Sehgal N, Dunbar EE, Epter R (2007) A systematic review of therapeutic facet joint interventions in chronic spinal pain. Pain Physician 10:229–253

    PubMed  Google Scholar 

  60. Staal JB, de Bie R, de Vet HC, Hildebrandt J, Nelemans P (2008) Injection therapy for subacute and chronic low-back pain. Cochrane Database Syst Rev CD001824. doi:10.1002/14651858.CD001824.pub3

  61. Geurts JW, van Wijk RM, Stolker RJ, Groen GJ (2001) Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Reg Anesth Pain Med 26:394–400. doi:10.1053/rapm.2001.23673

    CAS  PubMed  Google Scholar 

  62. Schofferman J, Kine G (2004) Effectiveness of repeated radiofrequency neurotomy for lumbar facet pain. Spine (Phila Pa 1976) 29:2471–2473

    Article  Google Scholar 

  63. Onofrio B, Yaksh T, Arnold P (1981) Continuous low-dose intrathecal morphine administration in the treatment of chronic pain of malignant origin. Mayo Clin Proc 56:516–520

    CAS  PubMed  Google Scholar 

  64. Levy R, Salzman D (1997) Implanted drug delivery systems for control of chronic pain. In: North R, Levy R (eds) Neurosurg. Manag. Pain. Springer, New York, pp 302–324

    Chapter  Google Scholar 

  65. Prager J (2002) Neuraxial medication delivery: the development and maturity of a concept for treating chronic pain of spinal origin. Spine (Phila Pa 1976) 27:2593–2605

    Article  Google Scholar 

  66. Raphael JH, Duarte RV, Southall JL, Nightingale P, Kitas GD (2013) Randomised, double-blind controlled trial by dose reduction of implanted intrathecal morphine delivery in chronic non-cancer pain. BMJ Open 3:e003061

    Article  PubMed  PubMed Central  Google Scholar 

  67. Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150:971–979. doi:10.1126/science.150.3699.971

    Article  CAS  PubMed  Google Scholar 

  68. Linderoth B, Foreman RD (1999) Physiology of spinal cord stimulation: review and update. Neuromodulation 2:150–164. doi:10.1046/j.1525-1403.1999.00150.x

    Article  CAS  PubMed  Google Scholar 

  69. NICE (2008) Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin. In: NICE Technol. Apprais. Guid. [TA159]. http://www.nice.org.uk/guidance/ta159/. Accessed 26 Nov 2015

  70. Cameron T (2004) Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review. J Neurosurg 100:254–267

    PubMed  Google Scholar 

  71. Kumar K, Taylor RS, Jacques L, Eldabe S, Meglio M, Molet J, Thomson S, O’Callaghan J, Eisenberg E, Milbouw G, Buchser E, Fortini G, Richardson J, North RB (2008) The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation. Neurosurgery 63:762–770. doi:10.1227/01.NEU.0000325731.46702.D9

    Article  PubMed  Google Scholar 

  72. Sparkes E, Duarte RV, Mann S, Lawrence TR, Raphael JH (2015) Analysis of psychological characteristics impacting spinal cord stimulation treatment outcomes: a prospective assessment. Pain Physician 18:E369–E377

    PubMed  Google Scholar 

  73. Linderoth B, Foreman RD (2006) Mechanisms of spinal cord stimulation in painful syndromes: role of animal models. Pain Med 7:S14–S26. doi:10.1111/j.1526-4637.2006.00119.x

    Article  Google Scholar 

  74. Wu M, Linderoth B, Foreman RD (2008) Putative mechanisms behind effects of spinal cord stimulation on vascular diseases: a review of experimental studies. Auton Neurosci 138:9–23. doi:10.1016/j.autneu.2007.11.001

    Article  PubMed  PubMed Central  Google Scholar 

  75. Claeys LG, Horsch S (1996) Transcutaneous oxygen pressure as predictive parameter for ulcer healing in endstage vascular patients treated with spinal cord stimulation. Int Angiol 15:344–349

    CAS  PubMed  Google Scholar 

  76. Amann W, Berg P, Gersbach P, Gamain J, Raphael JH, Ubbink DT (2003) Spinal cord stimulation in the treatment of non-reconstructable stable critical leg ischaemia: results of the European Peripheral Vascular Disease Outcome Study (SCS-EPOS). Eur J Vasc Endovasc Surg 26:280–286. doi:10.1053/ejvs.2002.1876

    Article  CAS  PubMed  Google Scholar 

  77. Norrsell H, Eliasson T, Albertsson P, Augustinsson LE, Emanuelsson H, Eriksson P, Mannheimer C (1998) Effects of spinal cord stimulation on coronary blood flow velocity. Coron Artery Dis 9:273–278

    Article  CAS  PubMed  Google Scholar 

  78. Kingma JG, Linderoth B, Ardell JL, Armour JA, DeJongste MJ, Foreman RD (2001) Neuromodulation therapy does not influence blood flow distribution or left-ventricular dynamics during acute myocardial ischemia. Auton Neurosci 91:47–54. doi:10.1016/S1566-0702(01)00285-5

    Article  PubMed  Google Scholar 

  79. Hautvast RWM, Blanksma PK, Dejongste MJL, Pruim J, Van Der WE, Vaalburg W, Lie KI (1996) Effect of spinal cord stimulation on myocardial blood flow assessed by positron emission tomography in patients with refractory angina pectoris. Am J Cardiol 77:462–467

    Article  CAS  PubMed  Google Scholar 

  80. Börjesson M, Andrell P, Lundberg D, Mannheimer C (2008) Spinal cord stimulation in severe angina pectoris—a systematic review based on the Swedish Council on Technology assessment in health care report on long-standing pain. Pain 140:501–508. doi:10.1016/j.pain.2008.10.016

    Article  PubMed  Google Scholar 

  81. Taylor RS, De Vries J, Buchser E, Dejongste MJL (2009) Spinal cord stimulation in the treatment of refractory angina: systematic review and meta-analysis of randomised controlled trials. BMC Cardiovasc Disord 9:13. doi:10.1186/1471-2261-9-13

    Article  PubMed  PubMed Central  Google Scholar 

  82. Eldabe S, Thomson S, Duarte R, Brookes M, DeBelder M, Raphael J, Davies E, Taylor R (2016) The effectiveness and cost-effectiveness of spinal cord stimulation for refractory angina (RASCAL Study): a pilot randomized controlled trial. Neuromodulation 19:60–70

    Article  PubMed  Google Scholar 

  83. Rasche D, Rinaldi PC, Young RF, Tronnier VM (2006) Deep brain stimulation for the treatment of various chronic pain syndromes. Neurosurg Focus 21:E8. doi:10.3171/foc.2006.21.6.10

    Article  PubMed  Google Scholar 

  84. Bittar RG, Kar-Purkayastha I, Owen SL, Bear RE, Green A, Wang S, Aziz TZ (2005) Deep brain stimulation for pain relief: a meta-analysis. J Clin Neurosci 12:515–519. doi:10.1016/j.jocn.2004.10.005

    Article  PubMed  Google Scholar 

  85. Boccard SGJ, Pereira EAC, Aziz TZ (2015) Deep brain stimulation for chronic pain. J Clin Neurosci 22:1537–1543. doi:10.1016/j.jocn.2015.04.005

    Article  PubMed  Google Scholar 

  86. NICE (2011) Deep brain stimulation for refractory chronic pain syndromes (excluding headache). NICE Interv Proced Guid 382:2–7

  87. Cruccu G, Aziz TZ, Garcia-Larrea L, Hansson P, Jensen TS, Lefaucheur J-P, Simpson BA, Taylor RS (2007) EFNS guidelines on neurostimulation therapy for neuropathic pain. Eur J Neurol 14:952–970. doi:10.1111/j.1468-1331.2007.01916.x

    Article  CAS  PubMed  Google Scholar 

  88. Boccard SGJ, Pereira EAC, Moir L, Aziz TZ, Green AL (2013) Long-term outcomes of deep brain stimulation for neuropathic pain. Neurosurgery 72:221–230. doi:10.1227/NEU.0b013e31827b97d6

    Article  PubMed  Google Scholar 

  89. Rosen AC, Ramkumar M, Nguyen T, Hoeft F (2009) Noninvasive transcranial brain stimulation and pain. Curr Pain Headache Rep 13:12–17

    Article  PubMed  PubMed Central  Google Scholar 

  90. Marlow NM, Bonilha HS, Short EB (2013) Efficacy of transcranial direct current stimulation and repetitive transcranial magnetic stimulation for treating fibromyalgia syndrome: a systematic review. Pain Pract 13:131–145. doi:10.1111/j.1533-2500.2012.00562.x

    Article  PubMed  Google Scholar 

  91. Reinert A, Treede R, Bromm B (2000) The pain inhibiting pain effect: an electrophysiological study in humans. Brain Res 862:103–110

    Article  CAS  PubMed  Google Scholar 

  92. Wand-Tetley JI (1956) Historical methods of counter-irritation. Ann Phys Med 3:90–99

    CAS  PubMed  Google Scholar 

  93. Carroll D, Ra M, Hj M, Fairman F, Tramèr M, Leijon G (2000) Transcutaneous electrical nerve stimulation (TENS) for chronic pain (Review). Cochrane Libr 4:1–42

    Google Scholar 

  94. Kane K, Taub A (1975) A history of local electrical analgesia. Pain 1:125–138

    Article  CAS  PubMed  Google Scholar 

  95. Johnson MI (2014) Transcutaneous electrical nerve stimulation (TENS): research to support clinical practice. Oxford University Press, Oxford

    Book  Google Scholar 

  96. Nash T, Williams J, Machin D (1990) TENS: does the type of stimulus really matter? Pain Clin 3:161–168

    Google Scholar 

  97. McQuay H, Moore R, Eccleston C, Morley S, Williams AC (1997) Systematic review of outpatient services for chronic pain control. Health Technol Assess (Rockv) 1:138

    Google Scholar 

  98. Raphael JH, Raheem TA, Southall JL, Bennett A, Ashford RL, Williams S (2011) Randomized double-blind sham-controlled crossover study of short-term effect of percutaneous electrical nerve stimulation in neuropathic pain. Pain Med 12:1515–1522. doi:10.1111/j.1526-4637.2011.01215.x

    Article  PubMed  Google Scholar 

  99. Turnbull A (1850) Tincture of capsaicin as a remedy for chilblains and toothache. Dublin Free Press, Dublin, pp 95–96

    Google Scholar 

  100. Szallasi A, Blumberg PM (1999) Vanilloid (Capsaicin) receptors and mechanisms. Pharmacol Rev 51:159–212

    CAS  PubMed  Google Scholar 

  101. Anand P, Bley K (2011) Topical capsaicin for pain management: therapeutic potential and mechanisms of action of the new high-concentration capsaicin 8 patch. Br J Anaesth 107:490–502. doi:10.1093/bja/aer260

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  102. Jones VM, Moore KA, Peterson DM (2011) Capsaicin 8% Topical Patch (Qutenza)—a review of the evidence. J Pain Palliat Care Pharmacother

  103. Maihofner C, Heskamp M-L (2013) Prospective, non-interventional study on the tolerability and analgesic effectiveness over 12 weeks after a single application of capsaicin 8% cutaneous patch in 1044 patients with peripheral neuropathic pain: first results of the QUEPP study. Curr Med Res Opin 29:673–683. doi:10.1185/03007995.2013.792246

    Article  CAS  PubMed  Google Scholar 

  104. Health and Social Care Information Centre (2014) Prescription cost analysis—England 2013. HSCIC 677

  105. Oosterveld FG, Rasker JJ (1994) Treating arthritis with locally applied heat or cold. Semin Arthritis Rheum 24:82–90

    Article  CAS  PubMed  Google Scholar 

  106. Brosseau L, Yonge K a, Robinson V, Marchand S, Judd M, Wells G, Tugwell P (2003) Thermotherapy for treatment of osteoarthritis. Cochrane Database Syst Rev CD004522. doi:10.1016/S0031-9406(05)60490-7

  107. Malanga GA, Nadler SF (1999) Nonoperative treatment of low back pain. Mayo Clin Proc 74:1135–1148. doi:10.4065/74.11.1135

    Article  CAS  PubMed  Google Scholar 

  108. Lehmann JF, Warren CG, Scham SM (1974) Therapeutic heat and cold. Clin Orthop Relat Res 99:207–245

    Article  Google Scholar 

  109. Le Bars D, Dickenson AH, Besson JM (1979) Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurones in the rat. Pain 6:283–304

    Article  PubMed  Google Scholar 

  110. Moont R, Pud D, Sprecher E, Sharvit G, Yarnitsky D (2010) “Pain inhibits pain” mechanisms: is pain modulation simply due to distraction? Pain 150:113–120. doi:10.1016/j.pain.2010.04.009

    Article  PubMed  Google Scholar 

  111. Melzack R (1999) From the gate to the neuromatrix. Pain 82:S121–S126

    Article  Google Scholar 

  112. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D (2006) Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 10:287–333

    Article  PubMed  Google Scholar 

  113. Price C, Hoggart B, Olukoga O, Williams ACDC, Bottle A (2012) National Pain Audit Final Report 2010–2012

  114. Sabers S (2003) The role of physical therapy in chronic pain. In: Rice A, Warfield C, Justins D, Eccleston C (eds) Clin. Pain Manag. Chronic Pain. Arnold, London, pp 313–324

    Google Scholar 

  115. Hayden J, Van Tulder M, Malmivaara A, Koes B (2005) Exercise therapy for treatment of non-specific low back pain. Cochrane Database Syst Rev 2:1–83

    Google Scholar 

  116. Engel J (2013) Evaluation and pain management. In: Pendleton H, Schultz-Krohn W (eds) Pendretti’s Occup. Ther, 7th edn. Elsevier, Mosby, p 1328

    Google Scholar 

  117. Claxton AJ, Cramer J, Pierce C (2001) A systematic review of the associations between dose regimens and medication compliance. Clin Ther 23:1296–1310. doi:10.1016/S0149-2918(01)80109-0

    Article  CAS  PubMed  Google Scholar 

  118. Turk DC, Monarch E (2002) Biopsychosocial perspective on chronic pain. In: Turk D, Gatchel RJ (eds) Psychological approaches to pain management, 2nd edn. Guilford Press, New York, NY, p 590

    Google Scholar 

  119. Williams S (2013) Pain Management Programmes 2013 National Directory of Services

  120. Jeffery MM, Butler M, Stark A, Kane RL (2011) Multidisciplinary pain programs for chronic noncancer pain. Agency for Healthcare Research and Quality (US), Rockville

    Google Scholar 

  121. Loeser JD, Turk DC (2001) Multidisciplinary pain management. In: Loeser JD (ed) Bonica’s Management Pain, 3rd edn. Lippincott, Williams & Wilkins, Philadelphia, pp 2069–2079

    Google Scholar 

  122. British Pain Society (2013) The British Pain Society Guidelines for Pain Management Programmes for adults

  123. Beck A, Rush A, Shaw B, Emery G (1979) Cognitive therapy of depression. Guilford Press, New York

    Google Scholar 

  124. Eccleston C (2001) Role of psychology in pain management. Br J Anaesth 87:144–152. doi:10.1093/bja/87.1.144

    Article  CAS  PubMed  Google Scholar 

  125. Turk D, Meichenbaum D, Genest M (1983) Pain and behavioral medicine: a cognitive–behavioral perspective. Guilford Press, New York

    Google Scholar 

  126. Bogaards MC, ter Kuile MM (1994) Treatment of recurrent tension headache: a meta-analytic review. Clin J Pain 10:174–190

    Article  CAS  PubMed  Google Scholar 

  127. Morley S, Eccleston C, Williams A (1999) Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain 80:1–13

    Article  CAS  PubMed  Google Scholar 

  128. Hoffman B, Papas R, Chatkoff D, Kerns R (2007) Meta-analysis of psychological interventions for chronic low back pain. Heal Psychol 26:1–9. doi:10.1037/0278-6133.26.1.1

    Article  Google Scholar 

  129. Henschke N, Ostelo R, Van Tulder M, Vlaeyen J, Morley S, Assendelft W, Main C (2010) Behavioural treatment for chronic low-back pain (Review). Cochrane Database Syst Rev 7:1–124

    Google Scholar 

  130. Williams ACDC, Eccleston C, Morley S (2012) Psychological therapies for the management of chronic pain (excluding headache) in adults (Review). Cochrane Libr 11:1–107

    Google Scholar 

  131. Moore RK, Groves D, Bateson S, Barlow P, Hammond C, Leach AA, Chester MR (2005) Health related quality of life of patients with refractory angina before and one year after enrolment onto a refractory angina program. Eur J Pain 9:305–310. doi:10.1016/j.ejpain.2004.07.013

    Article  CAS  PubMed  Google Scholar 

  132. Moore RKG, Groves DG, Bridson JD, Grayson AD, Wong H, Leach A, Lewin RJP, Chester MR (2007) A brief cognitive–behavioral intervention reduces hospital admissions in refractory angina patients. J Pain Symptom Manag 33:310–316. doi:10.1016/j.jpainsymman.2006.10.009

    Article  Google Scholar 

  133. Hayes SC, Strosahl KD, Wilson KG (1999) Acceptance and commitment therapy: an experiential approach to behavior change. Guilford Press, New York

    Google Scholar 

  134. Hayes S (2004) Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behav Ther 35:639–665. doi:10.1016/S0005-7894(04)80013-3

    Article  Google Scholar 

  135. Hayes S (2004) Acceptance and commitment therapy and the new behaviour therapies. In: Hayes SC, Follette V, Linehan M (eds) Mindfulness and acceptance: expanding the cognitive–behavioral tradition. Guilford Press, New York, pp 1–29

    Google Scholar 

  136. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J (2006) Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther 44:1–25. doi:10.1016/j.brat.2005.06.006

    Article  PubMed  Google Scholar 

  137. McCracken LM, Morley S (2014) The psychological flexibility model: a basis for integration and progress in psychological approaches to chronic pain management. J Pain 15:221–234. doi:10.1016/j.jpain.2013.10.014

    Article  PubMed  Google Scholar 

  138. Sturgeon J (2014) Psychological therapies for the management of chronic pain. Psychol Res Behav Manag 7:115–124. doi:10.2147/PRBM.S44762

    Article  PubMed  PubMed Central  Google Scholar 

  139. Kabat-Zinn J (1994) Wherever you go, there you are: mindfulness meditation in everyday life. Hyperion, New York

    Google Scholar 

  140. Veehof MM, Oskam M-J, Schreurs KMG, Bohlmeijer ET (2011) Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain 152:533–542. doi:10.1016/j.pain.2010.11.002

    Article  PubMed  Google Scholar 

  141. Hann KEJ, McCracken LM (2014) A systematic review of randomized controlled trials of Acceptance and Commitment Therapy for adults with chronic pain: outcome domains, design quality, and efficacy. J Context Behav Sci 3:1–39. doi:10.1016/j.jcbs.2014.10.001

    Article  Google Scholar 

Download references

Acknowledgments

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Faculty of Health Education and Life Sciences, Birmingham City University, Birmingham, UK

    Nicholas Hylands-White & Jon H. Raphael

  2. Institute of Applied Health Research, University of Birmingham, Birmingham, UK

    Rui V. Duarte

  3. Department of Pain Management, Russells Hall Hospital, Dudley, UK

    Jon H. Raphael

  4. 80 Knightsfield, Welwyn Garden City, Hertfordshire, AL8 7HB, UK

    Nicholas Hylands-White

Authors
  1. Nicholas Hylands-White
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rui V. Duarte
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jon H. Raphael
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicholas Hylands-White.

Ethics declarations

Conflict of interest

NHW, RVD, and JHR declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hylands-White, N., Duarte, R.V. & Raphael, J.H. An overview of treatment approaches for chronic pain management. Rheumatol Int 37, 29–42 (2017). https://doi.org/10.1007/s00296-016-3481-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-016-3481-8

Keywords

Search

Navigation