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Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)

Rolf‐Detlef TreedeMedical Faculty Mannheim of Heidelberg University, Mannheim, GermanyWinfried RiefDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, GermanyAntonia BarkeDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, GermanyQasim AzizCentre for Neuroscience and Trauma, Wingate Institute of Neurogastroenterology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, United KingdomMike BennettAcademic Unit of Palliative Care, University of Leeds, Leeds, United KingdomRafael BenolielDepartment of Diagnostic Sciences, Rutgers School of Dental Medicine, Rutgers, Newark, NJ, United StatesMilton CohenSt Vincent's Clinical School, UNSW, Sydney, New South Wales, AustraliaStefan EversDepartment of Neurology, Krankenhaus Lindenbrunn, Faculty of Medicine, University of Münster, Münster, GermanyNanna Brix FinnerupDepartment of Clinical Medicine, Danish Pain Research Center, Aarhus University, Aarhus, DenmarkMichael B. FirstNew York State Psychiatric InstituteMaria Adele GiamberardinoDepartment of Medicine and Science of Aging, CeSI-MeT, G D'Annunzio University of Chieti, Chieti, ItalyStein KaasaDepartment of Oncology, Oslo University Hospital, Oslo, NorwayBeatrice KorwisiDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, GermanyEva KosekDepartment of Clinical Neuroscience, Karolinska Institute, and Department of Neuroradiology, Karolinska University Hospital, Stockholm, SwedenPatricia Lavand’hommeDepartment of Anesthesiology, Acute Postoperative Pain Service, Saint Luc Hospital, Catholic University of Louvain, Brussels, BelgiumMichael K. NicholasUniversity of Sydney Medical School, Sydney, AustraliaSerge PerrotPain Clinic, Hotel Dieu Hospital, Paris Descartes University, Paris, FranceJoachim ScholzDepartments of Anesthesiology and Pharmacology, Columbia University, New York, NY, United StatesStephan A. SchugDiscipline of Anaesthesiology and Pain Medicine, Medical School, University of Western Australia, Perth, AustraliaBlair H. SmithGenomics (United Kingdom)Peter SvenssonDepartment of Dental Medicine, Karolinska Institute, Huddinge, SwedenJohan W.S. VlaeyenSponsorships or competing interests that may be relevant to content are disclosed at the end of this articleShuu‐Jiun WangThe Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

2018en

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Annotatsiya

Chronic pain is a major source of suffering. It interferes with daily functioning and often is accompanied by distress. Yet, in the International Classification of Diseases, chronic pain diagnoses are not represented systematically. The lack of appropriate codes renders accurate epidemiological investigations difficult and impedes health policy decisions regarding chronic pain such as adequate financing of access to multimodal pain management. In cooperation with the WHO, an IASP Working Group has developed a classification system that is applicable in a wide range of contexts, including pain medicine, primary care, and low-resource environments. Chronic pain is defined as pain that persists or recurs for more than 3 months. In chronic pain syndromes, pain can be the sole or a leading complaint and requires special treatment and care. In conditions such as fibromyalgia or nonspecific low-back pain, chronic pain may be conceived as a disease in its own right; in our proposal, we call this subgroup "chronic primary pain." In 6 other subgroups, pain is secondary to an underlying disease: chronic cancer-related pain, chronic neuropathic pain, chronic secondary visceral pain, chronic posttraumatic and postsurgical pain, chronic secondary headache and orofacial pain, and chronic secondary musculoskeletal pain. These conditions are summarized as "chronic secondary pain" where pain may at least initially be conceived as a symptom. Implementation of these codes in the upcoming 11th edition of International Classification of Diseases will lead to improved classification and diagnostic coding, thereby advancing the recognition of chronic pain as a health condition in its own right.

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DOI: 10.1097/j.pain.0000000000001384

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