Groups were organized thematically based on the continuum of pain.
The CONTINUUM of PAIN: the characterization of pain as a temporal process, beginning with an acute stage, which may progress to a chronic state of variable duration. Chronic pain may start early after injury or surgery, because of an individual’s susceptibility, through mechanisms activated in the acute setting.
Prevention of Acute and Chronic Pain
Primary pain prevention focuses on reducing pain from injuries or diseases. Secondary prevention focuses on reducing the likelihood that acute pain transitions into chronic pain. Tertiary prevention interventions attempt to limit the development of disabilities and other complications of chronic pain.
Acute Pain and Acute Pain Management
Acute pain is a time limited and expected physiologic effect of trauma, disease, surgery or illness that may progress to a chronic pathological state. It may be treated through self-management, pharmacological or non-pharmacological approaches.
Transition from Acute to Chronic Pain
Acute pain may progress into a persistent painful condition with the nature of the initial insult and various patient-related risk factors as contributing factors. Chronic pain may start early after injury, surgery, or other precipitating factors through mechanisms activated in the acute setting. The cause of this transition is often unclear and the mechanisms by which it occurs are complex.
Chronic Pain and Chronic Pain Management
Chronic pain is a complex biopsychosocial condition that has a distinct pathology with biological, psychological, and cognitive correlates, that may interfere with many aspects of a person’s life (high impact chronic pain). Chronic pain may require a biopsychosocial approach to multidisciplinary, multimodal and integrated care.
Disparities: Extends across the continuum of pain
Health disparities in pain occurrence, assessment, access to and quality of treatment, and outcomes adversely affect vulnerable populations. Increased risk for disparities is associated with race or ethnicity, religion, socioeconomic status, gender, age, mental health, cognitive, disability, sex or gender identity, and other characteristics linked to discrimination or exclusion.
Cross-cutting elements to be considered across relevant work groups
- Epidemiology: prevalence, onset, course, impact, use of and access to services, outcomes, consequences, economic burden, access to care, and categorization by condition,
- Diagnosis and assessment: phenotyping, genotyping
- Susceptibility and resiliency: underlying environmental and biopsychosocial mechanisms
- Biopsychosocial mechanisms: disease and treatment response
- Lifespan: disease progression, age relevance, palliative care, unique populations
- Treatment: biopsychosocial approach to self-management, pharmacological, and non-pharmacological interventions, mitigation of adverse treatment effects, comparative effectiveness research, patient centered outcomes research, health systems of care
- Dissemination and implementation: individualized, patient centered, multidisciplinary, multimodal, integrated treatment , health services research, patient and care provider education, use of non-evidence based treatments, risk benefit assessments of current care
- Research tools and infrastructure: basic and clinical research resources: including pain registries, big data initiatives, health care systems, emerging information technologies, data collection tools
- Translational science: basic research into the clinic: animal models and reverse translation