Phys.theory: MS: pain in MS
DEFINIon
“An unpleasant sensory and emotional experience associated with, or resembling that associated
with, actual or potential tissue damage.”
“the product of elaborate processing by the brain of a variety of neural signals.”
Subjective experience and multidimensional.
6 keynotes and etymology
Pijn heeft een geheugen
Pijn is een ervaring
Externe stimuls
- Hersenen verwerken info
- Beslissen wat pijnlijke stimulus is
Afhankelijk van omstandigheden
TYPES OF PAIN
1. BASED ON DURATION
Acute pain
- Lasts until the noxious pain stimulus is taken away/underlying damage has healed.
- Geneest direct
Chronic pain
- Lasting more than 12 weeks
- Most common human health problem
2. BASED ON UNDERLYING MECHANISMS
2.1. NOCICEPTIVE
As a response to a tissue injury, nociceptors become active
- Usually an Inflammation accompanies
- Strain, sprain, arthritis,…
“Pain that arises from actual or threatened damage to non-neural tissue and is due to
the activation of nociceptors.”
- Non neural tissue= spieren & andere lichaamsdelen
Schadelijke stimulus
- Signal geven
- Via RM naar hersenen
Note: Patients can have a combination of nociceptive and neuropathic pain.”1
2.2. NEUROPATHIC
Direct injury to nerves of PNS or CNS
Burning/electric sensations
Reflex sympathetic dystrophy (complex regional pain syndrome), phantom limb pain
“Pain caused by a lesion or disease of the somatosensory nervous system”.
Schade direct aan perifere/ central zenuw
Note: Patients can have a combination of nociceptive and neuropathic pain.”
2.3. MIXED
Nala Melis Pagina 1
, Phys.theory: MS: pain in MS
“Mixed pain is a complex overlap of the different known pain types (nociceptive, neuropathic, nociplastic)
in any combination, acting simultaneously and/or concurrently to cause pain in the same body area.
- mechanism may be more clinically predominant at any pint of time.
- Mixed pain can be acute or chronic.
2.4. NOCIPLASTIC
“Pain that arises from altered nociception despite no clear evidence of actual or threatened tissue
damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the
somatosensory system causing the pain.
3. OVERVIEW
O’Connor et. al. 2007. Pain associated with multiple sclerosis: Systematic review and proposed
classification
- Dysesthesia: “An unpleasant abnormal sensation, whether spontaneous or evoked. Special
cases of dysesthesia include hyperalgesia and allodynia. A dysesthesia should always be
unpleasant and a paresthesia should not be unpleasant…”
Truini et al 2013. A mechanismbased classification of pain in MS
Nala Melis Pagina 2
DEFINIon
“An unpleasant sensory and emotional experience associated with, or resembling that associated
with, actual or potential tissue damage.”
“the product of elaborate processing by the brain of a variety of neural signals.”
Subjective experience and multidimensional.
6 keynotes and etymology
Pijn heeft een geheugen
Pijn is een ervaring
Externe stimuls
- Hersenen verwerken info
- Beslissen wat pijnlijke stimulus is
Afhankelijk van omstandigheden
TYPES OF PAIN
1. BASED ON DURATION
Acute pain
- Lasts until the noxious pain stimulus is taken away/underlying damage has healed.
- Geneest direct
Chronic pain
- Lasting more than 12 weeks
- Most common human health problem
2. BASED ON UNDERLYING MECHANISMS
2.1. NOCICEPTIVE
As a response to a tissue injury, nociceptors become active
- Usually an Inflammation accompanies
- Strain, sprain, arthritis,…
“Pain that arises from actual or threatened damage to non-neural tissue and is due to
the activation of nociceptors.”
- Non neural tissue= spieren & andere lichaamsdelen
Schadelijke stimulus
- Signal geven
- Via RM naar hersenen
Note: Patients can have a combination of nociceptive and neuropathic pain.”1
2.2. NEUROPATHIC
Direct injury to nerves of PNS or CNS
Burning/electric sensations
Reflex sympathetic dystrophy (complex regional pain syndrome), phantom limb pain
“Pain caused by a lesion or disease of the somatosensory nervous system”.
Schade direct aan perifere/ central zenuw
Note: Patients can have a combination of nociceptive and neuropathic pain.”
2.3. MIXED
Nala Melis Pagina 1
, Phys.theory: MS: pain in MS
“Mixed pain is a complex overlap of the different known pain types (nociceptive, neuropathic, nociplastic)
in any combination, acting simultaneously and/or concurrently to cause pain in the same body area.
- mechanism may be more clinically predominant at any pint of time.
- Mixed pain can be acute or chronic.
2.4. NOCIPLASTIC
“Pain that arises from altered nociception despite no clear evidence of actual or threatened tissue
damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the
somatosensory system causing the pain.
3. OVERVIEW
O’Connor et. al. 2007. Pain associated with multiple sclerosis: Systematic review and proposed
classification
- Dysesthesia: “An unpleasant abnormal sensation, whether spontaneous or evoked. Special
cases of dysesthesia include hyperalgesia and allodynia. A dysesthesia should always be
unpleasant and a paresthesia should not be unpleasant…”
Truini et al 2013. A mechanismbased classification of pain in MS
Nala Melis Pagina 2
