Cargando…

Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition

Pain after an acute Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) condition (post-COVID pain) is becoming a new healthcare emergency. Precision medicine refers to an evidence-based method of grouping patients based on their diagnostic/...

Descripción completa

Detalles Bibliográficos
Autores principales: Fernández-de-las-Peñas, César, Nijs, Jo, Neblett, Randy, Polli, Andrea, Moens, Maarten, Goudman, Lisa, Shekhar Patil, Madhura, Knaggs, Roger D., Pickering, Gisele, Arendt-Nielsen, Lars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9599440/
https://www.ncbi.nlm.nih.gov/pubmed/36289827
http://dx.doi.org/10.3390/biomedicines10102562
_version_ 1784816594436751360
author Fernández-de-las-Peñas, César
Nijs, Jo
Neblett, Randy
Polli, Andrea
Moens, Maarten
Goudman, Lisa
Shekhar Patil, Madhura
Knaggs, Roger D.
Pickering, Gisele
Arendt-Nielsen, Lars
author_facet Fernández-de-las-Peñas, César
Nijs, Jo
Neblett, Randy
Polli, Andrea
Moens, Maarten
Goudman, Lisa
Shekhar Patil, Madhura
Knaggs, Roger D.
Pickering, Gisele
Arendt-Nielsen, Lars
author_sort Fernández-de-las-Peñas, César
collection PubMed
description Pain after an acute Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) condition (post-COVID pain) is becoming a new healthcare emergency. Precision medicine refers to an evidence-based method of grouping patients based on their diagnostic/symptom presentation and then tailoring specific treatments accordingly. Evidence suggests that post-COVID pain can be categorized as nociceptive (i.e., pain attributable to the activation of the peripheral receptive terminals of primary afferent neurons in response to noxious chemical, mechanical, or thermal stimuli), neuropathic (i.e., pain associated with a lesion or disease of the somatosensory nervous system and limited to a “neuroanatomically plausible” distribution of the system), nociplastic (i.e., pain arising from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain), or mixed type (when two pain phenotypes co-exist). Each of these pain phenotypes may require a different treatment approach to maximize treatment effectiveness. Accordingly, the ability to classify post-COVID pain patients into one of these phenotypes would likely be critical for producing successful treatment outcomes. The 2021 International Association for the Study of Pain (IASP) clinical criteria and grading system provide a framework for classifying pain within a precision pain medicine approach. Here we present data supporting the possibility of grouping patients with post-COVID pain into pain phenotypes, using the 2021 IASP classification criteria, with a specific focus on nociplastic pain, which is probably the primary mechanism involved in post-COVID pain. Nociplastic pain, which is usually associated with comorbid symptomology (e.g., poor sleep quality, fatigue, cognitive–emotional disturbances, etc.) and is considered to be more difficult to treat than other pain types, may require a more nuanced multimodal treatment approach to achieve better treatment outcomes.
format Online
Article
Text
id pubmed-9599440
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-95994402022-10-27 Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition Fernández-de-las-Peñas, César Nijs, Jo Neblett, Randy Polli, Andrea Moens, Maarten Goudman, Lisa Shekhar Patil, Madhura Knaggs, Roger D. Pickering, Gisele Arendt-Nielsen, Lars Biomedicines Review Pain after an acute Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) condition (post-COVID pain) is becoming a new healthcare emergency. Precision medicine refers to an evidence-based method of grouping patients based on their diagnostic/symptom presentation and then tailoring specific treatments accordingly. Evidence suggests that post-COVID pain can be categorized as nociceptive (i.e., pain attributable to the activation of the peripheral receptive terminals of primary afferent neurons in response to noxious chemical, mechanical, or thermal stimuli), neuropathic (i.e., pain associated with a lesion or disease of the somatosensory nervous system and limited to a “neuroanatomically plausible” distribution of the system), nociplastic (i.e., pain arising from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain), or mixed type (when two pain phenotypes co-exist). Each of these pain phenotypes may require a different treatment approach to maximize treatment effectiveness. Accordingly, the ability to classify post-COVID pain patients into one of these phenotypes would likely be critical for producing successful treatment outcomes. The 2021 International Association for the Study of Pain (IASP) clinical criteria and grading system provide a framework for classifying pain within a precision pain medicine approach. Here we present data supporting the possibility of grouping patients with post-COVID pain into pain phenotypes, using the 2021 IASP classification criteria, with a specific focus on nociplastic pain, which is probably the primary mechanism involved in post-COVID pain. Nociplastic pain, which is usually associated with comorbid symptomology (e.g., poor sleep quality, fatigue, cognitive–emotional disturbances, etc.) and is considered to be more difficult to treat than other pain types, may require a more nuanced multimodal treatment approach to achieve better treatment outcomes. MDPI 2022-10-13 /pmc/articles/PMC9599440/ /pubmed/36289827 http://dx.doi.org/10.3390/biomedicines10102562 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Fernández-de-las-Peñas, César
Nijs, Jo
Neblett, Randy
Polli, Andrea
Moens, Maarten
Goudman, Lisa
Shekhar Patil, Madhura
Knaggs, Roger D.
Pickering, Gisele
Arendt-Nielsen, Lars
Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition
title Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition
title_full Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition
title_fullStr Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition
title_full_unstemmed Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition
title_short Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition
title_sort phenotyping post-covid pain as a nociceptive, neuropathic, or nociplastic pain condition
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9599440/
https://www.ncbi.nlm.nih.gov/pubmed/36289827
http://dx.doi.org/10.3390/biomedicines10102562
work_keys_str_mv AT fernandezdelaspenascesar phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition
AT nijsjo phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition
AT neblettrandy phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition
AT polliandrea phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition
AT moensmaarten phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition
AT goudmanlisa phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition
AT shekharpatilmadhura phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition
AT knaggsrogerd phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition
AT pickeringgisele phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition
AT arendtnielsenlars phenotypingpostcovidpainasanociceptiveneuropathicornociplasticpaincondition