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Hello. My name is Simon Haroutounian.
I'm an assistant professor of anesthesiology at Washington University School of Medicine.
I work as a clinical pharmacist in the
Multidisciplinary Pain Management Team at Washington University Pain Center.
In my talk today, we'll overview different approaches,
primarily pharmacological ones, for the management of chronic pain.
I will discuss developments and future directions.
In this talk, I will provide
some background on the prevalence and burden of chronic pain,
as well as, we'll look at different ways to classify chronic pain.
We will, then, discuss different biological and psychological factors that can contribute
to the chronification of pain or the transition from acute to chronic pain, if you will.
We'll discuss possible targets for interventions to avoid this pain chronification.
I will provide an overview of some of
the current approaches for managing chronic pain and
focus primarily on recent evidence on the efficacy of pharmacological therapies,
highlighting some interesting future directions.
So, let's start with some definitions.
ISP, or the International Association for the Study of Pain,
defines pain is an unpleasant sensory and
emotional experience associated with actual or potential tissue damage.
I would like to highlight the two sensory and emotional components.
Because while in acute pain,
the experience may be mostly sensory or biological,
in chronic pain the emotional experience tends to play
quite a dramatic role in how patients perceive their pain.
Pain is typically divided into acute and chronic.
While most of us can intuitively say what chronic pain is,
the definition of chronic pain has not been that straightforward.
So, it used to move between defined time cutoffs for pain duration,
to the idea that chronic pain is pain that
persists past normal healing time of a tissue that has been damaged.
The recent 2019 definition
comes back to duration and defines chronic pain
as pain that has been going on for more than three months.
This temporal definition is mainly due to the fact that we can't always
identify the tissue damage or the inciting event that triggered that chronic pain.