The International Classification of Diseases (ICD) published by the World Health Organization (WHO) is used to help “organise” medical conditions. However, chronic pain conditions have always played the “poor relations” to other medical conditions. While these classification systems reflect the developments in pain research over the last 2 decades, and they do not have clear treatment or management implications.
Are you suffering from chronic lower back pain (CLBP) that just won’t go away? Are you tired of having to continually struggle with your physiotherapists to try and “get by on a daily basis”? Do you feel you are on on a “hiding to nothing” when it comes to your back pain?
Though classified as a disorder of the musculoskeletal system, the condition is now seen as a central nervous system problem. Symptoms include increased sensitivity to pain, achy and stiff joints, fatigue, and specific tender points on the back, chest, arms, and legs. Migraines, sleep disorders, and irritable bowel syndrome are also common complaints.
The use, overuse and misuse of opioids in pain management is very topical.
For many years opioids have been regarded as the “gold standard” in pain management. Initially they were reserved for cancer pain but very quickly they found a role in treating acute and chronic pain. The use of the long-acting products in particular have come under the microscope in the USA and in Europe because of the associated side effects including death from drug overdose.