Chronic primary pain isn’t a primary diagnosis

Chronic primary pain as a primary diagnosis and as the target for (demonstrably ineffective) treatment is a flawed and retrogressive concept. Its definition is oxymoronic, describing most “primary” chronic pain as of musculoskeletal origin, which is actually poorly understood secondary pain.A label of chronic primary pain encourages referral of the problem back to patients owing to its self-generating, interpretive, or long term nature, but it is not a medical diagnosis and will not benefit patients. To “move on from a mindset of searching for a diagnosis”1 to a situation where so many heterogenous conditions are potentially included under one label seems premature.The renaming of reflex sympathetic dystrophy as complex regional pain syndrome (CRPS) in 1994 was a similarly retrogressive paradigm shift because it became a “pain syndrome” with no primary cause.2 Add in fibromyalgia, subacromial pain syndrome, and now half of musculoskeletal medicine.As an experienced GP, I am familiar with…
Read Original Article: Chronic primary pain isn’t a primary diagnosis »