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Acta Oncol. 2016 Jun;55(6):659-63. doi: 10.3109/0284186X.2016.1167958. Epub 2016 May 4.

Pain following cancer treatment: Guidelines for the clinical classification of predominant neuropathic, nociceptive and central sensitization pain.

Author information

1
a Pain in Motion International Research Group , www.paininmotion.be ;
2
b Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy , Vrije Universiteit Brussel , Belgium ;
3
c Department of Physical Medicine and Physiotherapy , University Hospital Brussels , Belgium ;
4
d Department of Oncology , University Hospital Brussels , Belgium ;
5
k Department of Physical Therapy , University of Granada , Spain ;
6
e Department of Physical Medicine and Rehabilitation , University Hospitals Leuven, Belgium & Department of Rehabilitation Sciences, KU Leuven - University of Leuven , Belgium ;
7
j Department of Rehabilitation Sciences , Ghent University , Ghent , Belgium ;
8
f Transcare, Transdisciplinairy Painmanagement Centre , Groningen , the Netherlands ;
9
i Rehabilitation Sciences and Physiotherapy, Faculty of Medicine , Antwerp University , Antwerp , Belgium ;
10
g De Berekuyl , Private practice for physiotherapy in oncology & lymphology , the Netherlands ;
11
h European College of Decongestive Lymphatic Therapy , the Netherlands ;
12
l Department of Health Sciences , Macquarie University , New South Wales , Australia.

Abstract

BACKGROUND:

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. In this paper we present an overview of nociceptive, neuropathic and central sensitization pain following cancer treatment, as well as the rationale, criteria and process for stratifying pain classification.

MATERIAL AND METHODS:

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. We, a team of 15 authors from 13 different centers, four countries and two continents have applied this classification algorithm to the cancer survivor population.

RESULTS:

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 and central sensitization pain. Step 1 builds on the established criteria for neuropathic pain diagnosis, while Step 2 applies a recently developed clinical method for classifying any pain as either predominant central sensitization pain, neuropathic or nociceptive pain to the cancer survivor population.

CONCLUSION:

The classification criteria allow identifying central sensitization pain following cancer treatment. The recognition of central sensitization pain in practice is an important development in the integration of pain neuroscience into the clinic, and one that is relevant for people undergoing and following cancer treatment.

PMID:
27142228
DOI:
10.3109/0284186X.2016.1167958
[Indexed for MEDLINE]

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