Diagnostic triumvirate of pain: from understanding to action

A.N. Barinov¹, M.N. Pluzhnikova²

¹I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow

²Institute of Higher Nervous Activity and Neurophysiology of RAS, Moscow

The article presents a new diagnostic concept of pain, assumming three basic types of pain syndromes: nociceptive, neuropathic and nociplastic. Medical risk factors of chronic pain are described. The article also covers in detail the questions concerning one of the most striking manifestations of social communication disorders in any pain syndromes — the pain catastrophizing. The modern approach to the treatment of pain syndromes implies the earliest possible prescription of drugs, regardless of their development etiological origin. Treatment patterns of each of the above pain types, involving the use of different drug groups aimed at different mechanisms of nociception and antinociception, are presented. Special attention is paid to individual methods of non-drug therapy, which can be used for any pain type. The article describes modern methods of short-term psychological interventions that  can improve the treatment efficacy: hypnotherapy and cognitive behavioral therapy. Understanding the pain syndrome type and the leading mechanisms of pain development in a particular patient allows to recommend individual therapy aimed at eliminating not only the symptoms, but also the underlying cause of the disease.

Keywords: nociceptive pain, neuropathic pain, nociplastic pain, catastrophizing, short-term psychological interventions, cognitive behavioral therapy, paracetamol, tramadol.

For citation: Barinov A.N., Pluzhnikova M.N. Diagnostic triumvirate of pain: from understanding to action. RMJ. 2021;4:54–58.