Diagnosis and Management of Pain in Parkinson's Disease: A New Approach
Pain is a frequent and disabling non-motor feature of Parkinson’s disease (PD). The recently proposed PD Pain Classification System (PD-PCS) allows for an association of pain with PD to be determined before being allocated to the main pain mechanism (i.e. nociceptive, neuropathic, and nociplastic)....
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| Veröffentlicht in: | Drugs & aging 2021-07, Vol.38 (7), p.559-577 |
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| container_title | Drugs & aging |
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| creator | Mylius, Veit Möller, Jens Carsten Bohlhalter, Stephan Ciampi de Andrade, Daniel Perez Lloret, Santiago |
| description | Pain is a frequent and disabling non-motor feature of Parkinson’s disease (PD). The recently proposed PD Pain Classification System (PD-PCS) allows for an association of pain with PD to be determined before being allocated to the main pain mechanism (i.e. nociceptive, neuropathic, and nociplastic). In this article, previous studies on treatments for pain in PD are summarized according to the pain mechanisms. A mechanistic approach to treatment is discussed. We suggest that the first step should be optimizing dopaminergic therapy before other therapy is started. When these treatments remain unsuccessful, further causes of pain must be considered. The role of drugs, invasive treatments, and physiotherapeutic interventions are discussed with a focus on older PD patients and considering polypharmacy, altered pharmacokinetics, and comorbidities. |
| doi_str_mv | 10.1007/s40266-021-00867-1 |
| format | Article |
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The recently proposed PD Pain Classification System (PD-PCS) allows for an association of pain with PD to be determined before being allocated to the main pain mechanism (i.e. nociceptive, neuropathic, and nociplastic). In this article, previous studies on treatments for pain in PD are summarized according to the pain mechanisms. A mechanistic approach to treatment is discussed. We suggest that the first step should be optimizing dopaminergic therapy before other therapy is started. When these treatments remain unsuccessful, further causes of pain must be considered. The role of drugs, invasive treatments, and physiotherapeutic interventions are discussed with a focus on older PD patients and considering polypharmacy, altered pharmacokinetics, and comorbidities.</description><identifier>ISSN: 1170-229X</identifier><identifier>EISSN: 1179-1969</identifier><identifier>DOI: 10.1007/s40266-021-00867-1</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Dyskinesia ; Dysphagia ; Geriatrics/Gerontology ; Internal Medicine ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Older people ; Pain ; Parkinson's disease ; Patients ; Pharmacology/Toxicology ; Pharmacotherapy ; Polypharmacy ; Quality of life ; Questionnaires ; Review Article ; Sleep</subject><ispartof>Drugs & aging, 2021-07, Vol.38 (7), p.559-577</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021</rights><rights>Copyright Springer Nature B.V. 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| subjects | Dyskinesia Dysphagia Geriatrics/Gerontology Internal Medicine Medical diagnosis Medicine Medicine & Public Health Older people Pain Parkinson's disease Patients Pharmacology/Toxicology Pharmacotherapy Polypharmacy Quality of life Questionnaires Review Article Sleep |
| title | Diagnosis and Management of Pain in Parkinson's Disease: A New Approach |
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