Update on chronic musculoskeletal pain: narrative review

• Published in: BrJP
• Main Authors: Tatiana Wscieklica, Marina Jacobucci Pellegrini, Ney Armando Meziat-Filho, Diogo Corrêa Maldonado, Eliane Florencio Gama
• Format: Article
• Language: English
• Published: Sociedade Brasileira para o Estudo da Dor 2024-08-01
• Subjects: chronic pain; models; models biopsychosocial; musculoskeletal pain
• Online Access: https://www.scielo.br/j/brjp/a/9QwGq5XNxG8kC8LJ888pKRr/?lang=en
• ISSN: 2595-0118; 2595-3192

BACKGROUND AND OBJECTIVES: There are conditions in which chronic musculoskeletal pain is present without apparent tissue damage, such as fibromyalgia or non-specific low back pain. In these cases, understanding the disease and treatment are challenges for patients, professionals and health services. Therefore, the aim of this study was to carry out a narrative review on chronic musculoskeletal pain, discuss current definitions and classifications and present different management strategies in order to contribute to clinical practice. CONTENTS: Chronic musculoskeletal pain, without apparent injury, is now considered a disease and has been updated in the International Code of Diseases 11 (ICD-11), being called primary chronic musculoskeletal pain. The main mechanism of this type of pain is nociplastic, in which there is no clear evidence of actual or potential tissue damage, causing the activation of peripheral nociceptors or evidence of disease or injury to the somatosensory system that causes the pain. CONCLUSION: Chronic musculoskeletal pain is now classified into subgroups: primary chronic pain, in which pain is understood as a disease; and secondary chronic pain, in which pain is a symptom that arises as part of a disease process. Emotional distress and functional disability are characteristic, but not exclusive, to primary chronic musculoskeletal pain, in which there are no tissue lesions or other diagnosis that explain the pain. Treatment strategies should be multimodal and multidisciplinary.