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[The chronically painful hand]

F Iselin1, M Peze, M Thetio

  • 1Unité de Chirurgie de la Main et de Traitement de la main douloureuse, Hôpital Max Fourestier, Nanterre.

Annales De Chirurgie De La Main Et Du Membre Superieur : Organe Officiel Des Societes De Chirurgie De La Main = Annals of Hand and Upper Limb Surgery
|January 1, 1995
PubMed
Summary
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Chronic pain is a complex syndrome with organic and psychological aspects, differing from acute pain. Effective management requires a multidisciplinary approach, integrating various therapies for optimal patient outcomes.

Area of Science:

  • Neurology
  • Psychology
  • Pain Medicine

Context:

  • Distinguishes acute pain as a warning signal from chronic pain as a pathological syndrome.
  • Highlights the dual organic and psychological components of chronic pain, often unrelated to the initial cause.

Purpose:

  • To differentiate between nociceptive pain treatable by addressing the cause and disafferentation pain refractory to surgery.
  • To emphasize the necessity of a multidisciplinary strategy for managing chronic pain.

Summary:

  • Chronic pain presents as a syndrome with both physical and psychological dimensions, diverging from the typical warning signal of acute pain.
  • Classifies pain into nociceptive (cause-treatable) and disafferentation (nerve transmission defect, surgery-resistant) types.
  • Advocates for a comprehensive treatment strategy involving surgery, medication, neurostimulation, physical therapy, and psychotherapy.

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Impact:

  • Informs clinical practice by clarifying pain classifications and treatment rationales.
  • Establishes the importance of a 'therapeutic alliance' in managing challenging chronic pain cases.
  • Promotes integrated care models for improved chronic pain patient outcomes.