Anatomy-Physiotherapy-logo

  • Italiano (Italia)
  • Français (France)
  • Portuguese (PT)
  • Deutsch (Deutschland)
  • Spanish (ES)
  • English (UK)
New english website, click here ->

           

  • Articles
    Evidence based articles
    • Musculoskeletal
      • Upper extremity
      • Lower extremity
      • Spine
    • Other
      • Nervous
      • Circulatory
      • Nutrition
      • Aging
      • Pain
      • Various
  • Art & Design
    Anatomy related art
  • Videos
    Webinars & more
  • Create account
    Personal pages & favourites
  • Login
    Login to A&P
Anatomy-Physiotherapy-logo
16 Jun2016

16 June 2016.

Written by Liesbeth Raymakers
Posted in Pain

16-06-2016 08:39:28
mindsofmalady
Image by: mindsofmalady

Pain following cancer treatment

In addition to fatigue, pain is the most frequent persistent symptom in cancer survivors. Clear guidelines for both the diagnosis and treatment of pain in cancer survivors are lacking.

Classification of pain is important as it may facilitate more specific targeting of treatment, pharmalogical and non-pharmalogical. For example, pain education is an effective but underused strategy for treating cancer pain. Physiotherapy for cancer pain, patient-centered and founded on a mechanisms-based classification of pain, has previously been shown to yield positive findings. 

Recently, a clinical method for classifying any pain as either predominant central sensitization pain, neuropathic or nociceptive pain was developed, based on a large body of research evidence and international expert opinion.  

The classification of pain following cancer treatment entails two steps: (1) examining the presence of neuropathic pain; and (2) using an algorithm for differentiating predominant nociceptive or central sensitization pain.

Step 1 builds on the established criteria for neuropathic pain diagnosis (nervous system lesion identifiable, specific pain and hyperalgesia distribution and presence of sensory abnormalities), while step 2 applies a recently developed clinical method (see illustration) for classifying any pain as either predominant central sensitization pain, neuropathic or nociceptive pain to the cancer survivor population.

This study presents an overview of nociceptive, neuropathic and central sensitization pain following cancer treatment.

Nociceptive pain is defined as pain attributable to the activation of the peripheral receptive terminals of primary afferent neurons in response to noxious chemical, mechanical or thermal stimuli, or as pain arising from actual or threat of damage to non-neural tissue and is due to the activation of nociceptors.

Neuropathic pain is defined as pain caused by a primary lesion or disease of the somatosensory nervous system.

Central sensitization implies increased neuronal response to stimuli in the central nervous system (i.e. central hyperexcitability) and reduced pain modulation. Often, "illogical" pain patterns are seen, outside the area of nociception. Overall sensory hypersensitivity in cancer survivors can be tested using quantitative sensory testing (QST), or the Central Sensitization Inventory (CSI). 

The study, which included a team of 15 authors from 13 different centers, 4 countries and 2 continents, applied this classification algorithm to the cancer survivor population.

To assess if pain is disproportionate to the extent of injury, knowledge of common sources of nociception in cancer survivors is required.

EMG, CT and MRI may be used to differentiate between nociceptive and neuropathic pain.

Plus, a multidimensional assessment of pain is warranted. This can be done using the Short-Form McGill Pain Questionnaire-2, tested in the cancer population. 

Having collected these measurements, the algorithm can be used to determine the extent of central sensitization and consequent therapeutic intervention.

Want know more about this research group and its studies? You can find it at paininmotion.be!

 

> From: Nijs et al., Acta Oncol 55 (2016) 659-663(Epub ahead of print). All rights reserved to Informa UK Ltd. Click here for the Pubmed summary.

author
Image by: author

Tags: neuropathic pain, nociception, cancer, Central sensitization, Guideline

Please log in or create an account to place comments. It's free and takes only a minute.

About the Author
Liesbeth Raymakers
Liesbeth Raymakers
Liesbeth Raymakers has been working as a Physiotherapist since 1998, mainly in hospital based care, ICU and intensive rehab. Originally from the Nethe...

Latest articles from this auhtor

  • Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: meta-analysis of randomized controlled trials.
  • A framework for fibromyalgia management for primary care providers.
  • Effect of resistance training on physical performance and fear of falling in elderly with different levels of physical well-being
  • Age-related effects of exercise training on diastolic function in heart failure with reduced ejection fraction: the Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study.
  • The importance of components of pulmonary rehabilitation, other than exercise training, in COPD
 

 

Login

  • Forgot your password?
  • Forgot your username?
  • Create an account
AP banner Sono 1

Related

  • Review of neuropathic pain screening and assessment tools.
  • Identification of neuropathic pain in patients with neck/upper limb pain: Application of a grading system and screening tools
  • Expectations and positive feelings and neuropathic pain
  • Ultrasound evaluation of focal neuropathies in athletes
  • Biopsychosocial factors and chronic upper limb pain

Newsletter

Subscribe to our weekly newsletter to receive all articles of the week in your mailbox.

 

Partners

enraf nonius

apa

fontys

vpt

kiné care

ICMSU

  • Home
  • About
  • Team
  • Advertise
  • Contact
  • Terms of Service
  • Privacy Policy
  • Jobs
  • Newsletter archive
AP-SMALL-WHITECopyright 2010 - 2023 Anatomy & Physiotherapy. All Rights Reserved.

Privacy Policy

AdBlock detected

We want to keep offering top-notch content for free. In order to keep up with the additional costs that we incurr with scaling our website, we need your help! Please turn off your adblocker or consider donating a small amount.

http://www.anatomy-physiotherapy.com/donate

Close
You can also just close this popup. It shows only once.
isApp.it
  • Articles
    Evidence based articles
    • Musculoskeletal
      • Upper extremity
        • Shoulder
        • Elbow
        • Wrist
        • Hand
      • Lower extremity
        • Hip
        • Knee
        • Ankle
        • Foot
      • Spine
        • Pelvis
        • Lumbar
        • Thoracic
        • Rib cage
        • Cervical
    • Other
      • Nervous
      • Circulatory
      • Nutrition
      • Aging
      • Pain
      • Various
  • Art & Design
    Anatomy related art
  • Videos
    Webinars & more
  • Create account
    Personal pages & favourites
  • Login
    Login to A&P
You are now being logged in using your Facebook credentials