A Review of Select Centralized Pain Syndromes: Relationship With Childhood Sexual Abuse, Opiate Prescribing, and Treatment Implications for the Primary Care Physician

Overview

Journal Health Serv Res Manag Epidemiol

Publisher Sage Publications

Specialty Public Health

Date 2017 May 3

PMID 28462250

Citations 4

Authors

David R Spiegel

Aparna Chatterjee

Aidan L Mccroskey

Tamana Ahmadi

Drew Simmelink

Edward C Oldfield 4th

Christopher R Pryor

Michael Faschan

Olivia Raulli

Affiliations

Soon will be listed here.

Abstract

Pain can be broadly divided into 3 classes, including nociceptive or inflammatory pain (protective), neuropathic (pathological, occurring after damage to the nervous system), or centralized (pathological, due to abnormal function but with no damage or inflammation to the nervous system). The latter has been posited to occur when descending analgesic pathways are attenuated and/or glutamatergic transmission is facilitated. Additionally, this "pain prone phenotype" can be associated with early life trauma and a suboptimal response to opiates. This article will review the relationships between centralized pain syndromes (ie, fibromyalgia, chronic low back pain), childhood sexual abuse, and opiate misuse. Finally, treatment implications, potentially effecting primary care physicians, will be discussed.

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