Authors
W.A. Sifuentes-Giraldo, J.L. Morell-Hita
Summary
Introduction
Chronic musculoskeletal pain is a very common problem in clinical practice. It affects all ages, especially women and low-income populations, and the prevalence of disability due to this condition increases in people over 60 years.
Etiopathogeny
Chronic musculoskeletal pain can be classified according to its biological mechanism in neuropathic pain (central and peripheral), muscular pain, inflammatory pain and mechanical/compressive pain. Determine the predominant mechanism is important because it allows to guide the diagnosis and therapeutic decisions. However, there may be more than a mechanism involved in a single patient.
Diagnosis
The clinical history and physical examination are essential in the diagnosis of chronic musculoskeletal pain, because there are no specific diagnostic tests and the presence of a pathological finding in a complementary test does not necessarily confirm that is the cause of pain in the patient.
References
Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011;25(2): 173-83.
Clauw DJ. Diagnosing and treating chronic musculoskeletal pain based on the underlying mechanism(s). Best Pract Res Clin Rheumatol. 2015; 29(1):6-19.
Dieppe P. Chronic musculoskeletal pain. BMJ 2013;346: bmj.f3146. ✔ Estrategia en enfermedades reumáticas y musculoesqueléticas del Sistema Nacional de Salud. Ministerio de Sanidad, Servicios Sociales e Igualdad 2013. Disponible en: http://www.msssi.gob.es/organizacion/sns/planCalidadSNS/pdf/Estrategia_en_enfermedades_reumaticas_Accesible.pdf
Hooten WM, Timming R, Belgrade M, Gaul J, Goertz M, Haake B, et al. Assessment and Management of Chronic Pain. Institute for Clinical Systems Improvement 2013. Disponible en: https://www.icsi.org/_asset/bw798b/ChronicPain.pdf
Rosenquist EWK. Evaluation of chronic pain in adults. UpToDate 2016. Disponible en: www.UpToDate.com
Salaffi F, Ciapetti A, Carotti M. Pain assessment strategies in patients with musculoskeletal conditions. Reumatismo. 2012;64(4): 216-29.
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