Chronic pain is included in the WHO International Classification of Diseases (ICD-11) (in 2 categories)

In May 2019, the World Health Organization (WHO) adopted a new edition of the International Classification of Diseases , ICD-11 .

It is the first version to include chronic pain, the International Association for the Study of Pain (IASP) said in a statement.

The classification of chronic pain was developed by an IASP working group in collaboration with WHO. Chronic pain is defined as pain that lasts or reappears for more than three months.

Chronic pain is classified into two categories: primary pain and secondary pain.

Primary chronic pain

Primary chronic pain is considered a disease in itself. It is characterized by a disability (disability) or emotional distress and is not better explained by another diagnosis of chronic pain.

Primary chronic pain includes generalized chronic pain (such as fibromyalgia , nonspecific low back pain, complex regional pain syndrome …), chronic musculoskeletal pain previously referred to as “nonspecific”, and head and primary conditions such as chronic pelvic pain and irritable bowel syndrome .

They are recognized as constituting a group of chronic pain syndromes for the first time in ICD-11.

The recently proposed definition of nociplastic pain may describe some of the underlying mechanisms. One of these mechanisms is that of central awareness .

Chronic secondary pain

Chronic secondary pain is a symptom of an underlying disease. It is classified in the following six categories:

  • The chronic cancer pain is chronic pain that is caused by cancer or its treatment, such as chemotherapy. She is represented for the first time in the CIM.
  • The post-surgical pain or chronic posttraumatic is chronic pain that develops or worsens after tissue trauma (accidental or surgical) and that persists beyond three months. She is also part of the CIM for the first time.
  • The chronic neuropathic pain is chronic pain caused by injury or disease of the nervous somatosensory system. Peripheral (peripheral nervous system ) and central ( central nervous system ) neuropathic pain is classified here. These diagnoses are also newly represented in the CIM.
  • The headache or secondary chronic orofacial pain include chronic forms of symptomatic headache (that is to say, due to a disease, distinguishing primary headache). Secondary chronic orofacial pain, such as chronic dental pain, completes this section.
  • The secondary chronic visceral pain is chronic pain due to an identified condition, from internal organs: the head or neck or thoracic regions, abdominal or pelvic. It can be caused by persistent inflammation, vascular mechanisms or mechanical factors.
  • The musculoskeletal secondary chronic pain is chronic pain in bones, joints and tendons caused by an underlying disease. It may be due to persistent inflammation, associated with structural changes or caused by impaired biomechanical function due to diseases of the nervous system.

The Task Force hopes that the inclusion of chronic pain in ICD-11 will promote the recognition of chronic pain as a health problem in its own right and help improve access to adequate treatment.

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