Chronic pain: a flawed and harmful dichotomisation

Kang and colleagues have concisely summarised the definitions and diagnosis of chronic pain.1 There are several major problems underlying the decision to label chronic pain a diagnosis and to subsequently dichotomise this complex entity into “primary” and “secondary” subtypes. The extensive links between the drug industry and the International Association for the Study of Pain taskforce (who created this ICD-11 code) should also be noted.23Dichotomisation of chronic pain into primary and secondary subtypes is fundamentally flawed and based on a total lack of understanding of the underlying high quality epidemiological research. The best evidence shows that chronic pain cannot be accurately diagnosed in terms of “causality” at the individual patient level. Structural abnormalities such as osteoarthritis and tendon tears merely increase the risk of chronic pain at the population level and cannot predict chronic pain in individual patients.456 Dichotomisation has the potential to do much harm in the real world—it…
Read Original Article: Chronic pain: a flawed and harmful dichotomisation »