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. 2011 Nov 11;5(2):365-372.
doi: 10.1016/j.eujps.2011.08.013.

Preventing Chronic Pain following Acute Pain: Risk Factors, Preventive Strategies, and their Efficacy

Kai McGreevy  1 , Michael M Bottros, Srinivasa N Raja
Affiliations

Preventing Chronic Pain following Acute Pain: Risk Factors, Preventive Strategies, and their Efficacy

Kai McGreevy et al. Eur J Pain Suppl. .

Abstract

Chronic pain is the leading cause of disability in the United States. The transition from acute to persistent pain is thought to arise from maladaptive neuroplastic mechanisms involving three intertwined processes, peripheral sensitization, central sensitization, and descending modulation. Strategies aimed at preventing persistent pain may target such processes. Models for studying preventive strategies include persistent post-surgical pain (PPP), persistent post-trauma pain (PTP) and post-herpetic neuralgia (PHN). Such entities allow a more defined acute onset of tissue injury after which study of the long-term effects is more easily examined. In this review, we examine the pathophysiology, epidemiology, risk factors, and treatment strategies for the prevention of chronic pain using these models. Both pharmacological and interventional approaches are described, as well as a discussion of preventive strategies on the horizon.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT.

Kai McGreevy, MD has nothing to disclose. Michael Bottros, MD has nothing to disclose. Srinivasa Raja, MD has nothing to disclose.

Figures

Figure 1
Figure 1. Schematic representation of multifactorial nature of neuropathic pain
Potential targets include peripheral sensitization, central sensitization and descending modulation (Adapted from Basbaum et al, 2009).
Figure 2
Figure 2. Schematic illustrating risk factors for the development of chronic pain throughout the perioperative continuum
(Adapted from Wu and Raja, Lancet, In press).
See this image and copyright information in PMC

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