Features and methods to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system: a Delphi expert consensus study

Muath A Shraim; Kathleen A Sluka; Michele Sterling; Lars Arendt-Nielsen; Charles Argoff; Karl S Bagraith; Ralf Baron; Helena Brisby; Daniel B Carr; Ruth L Chimenti; Carol A Courtney; Michele Curatolo; Beth D Darnall; Jon J Ford; Thomas Graven-Nielsen; Melissa C Kolski; Eva Kosek; Richard E Liebano; Shannon L Merkle; Romy Parker; Felipe J J Reis; Keith Smart; Rob J E M Smeets; Peter Svensson; Bronwyn L Thompson; Rolf-Detlef Treede; Takahiro Ushida; Owen D Williamson; Paul W Hodges

doi:10.1097/j.pain.0000000000002577

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Features and methods to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system: a Delphi expert consensus study

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Features and methods to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system: a Delphi expert consensus study

Muath A Shraim, Kathleen A Sluka, Michele Sterling, Lars Arendt-Nielsen, Charles Argoff, Karl S Bagraith, Ralf Baron, Helena Brisby, Daniel B Carr, Ruth L Chimenti, …

Pain (Amsterdam), Vol.163(9), pp.1812-1828

01/19/2022

DOI: 10.1097/j.pain.0000000000002577

PMCID: PMC9294075

PMID: 35319501

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https://cris.maastrichtuniversity.nl/en/publications/8cc61243-939b-4d69-845b-78d6b8bcf480View

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Abstract

Classification of musculoskeletal pain based on underlying pain mechanisms (nociceptive, neuropathic, and nociplastic pain) is challenging. In the absence of a gold standard, verification of features that could aid in discrimination between these mechanisms in clinical practice and research depends on expert consensus. This Delphi expert consensus study aimed to: (1) identify features and assessment findings that are unique to a pain mechanism category or shared between no more than 2 categories and (2) develop a ranked list of candidate features that could potentially discriminate between pain mechanisms. A group of international experts were recruited based on their expertise in the field of pain. The Delphi process involved 2 rounds: round 1 assessed expert opinion on features that are unique to a pain mechanism category or shared between 2 (based on a 40% agreement threshold); and round 2 reviewed features that failed to reach consensus, evaluated additional features, and considered wording changes. Forty-nine international experts representing a wide range of disciplines participated. Consensus was reached for 196 of 292 features presented to the panel (clinical examination-134 features, quantitative sensory testing-34, imaging and diagnostic testing-14, and pain-type questionnaires-14). From the 196 features, consensus was reached for 76 features as unique to nociceptive (17), neuropathic (37), or nociplastic (22) pain mechanisms and 120 features as shared between pairs of pain mechanism categories (78 for neuropathic and nociplastic pain). This consensus study generated a list of potential candidate features that are likely to aid in discrimination between types of musculoskeletal pain.

Details

Title: Subtitle: Features and methods to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system: a Delphi expert consensus study
Creators: Muath A Shraim - The University of Queensland
Kathleen A Sluka - Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA, United States
Michele Sterling - The University of Queensland
Lars Arendt-Nielsen - Aalborg University
Charles Argoff - Albany Medical College, Albany, NY, United States
Karl S Bagraith - Gold Coast Hospital
Ralf Baron - Division of Neurological Pain Research and Therapy, Department of Neurology at Neurozentrum (House D), Kiel, Germany
Helena Brisby - University of Gothenburg
Daniel B Carr - Tufts University
Ruth L Chimenti - University of Iowa
Carol A Courtney - Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
Michele Curatolo - University of Washington
Beth D Darnall - Stanford University
Jon J Ford - La Trobe University
Thomas Graven-Nielsen - Aalborg University
Melissa C Kolski - Feinberg School of Medicine, Shirley Ryan AbilityLab, Northwestern University, Chicago, IL, United States
Eva Kosek - Uppsala University Hospital
Richard E Liebano - Universidade Federal de São Carlos
Shannon L Merkle - Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
Romy Parker - University of Cape Town
Felipe J J Reis - Vrije Universiteit Brussel
Keith Smart - University College Dublin
Rob J E M Smeets - CIR Rehabilitation, Eindhoven, the Netherlands
Peter Svensson - Aarhus University
Bronwyn L Thompson - University of Otago
Rolf-Detlef Treede - Department of Neurophysiology, Neurophysiology Mannheim Center for Translational Neurosciences, Heidelberg University, Heidelberg, Germany
Takahiro Ushida - Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
Owen D Williamson - Simon Fraser University
Paul W Hodges - The University of Queensland
Resource Type: Journal article
Publication Details: Pain (Amsterdam), Vol.163(9), pp.1812-1828
DOI: 10.1097/j.pain.0000000000002577
PMID: 35319501
PMCID: PMC9294075
NLM abbreviation: Pain
eISSN: 1872-6623
Grant note: U24 NS112873 / NINDS NIH HHS
Language: English
Date published: 01/19/2022
Academic Unit: Iowa Neuroscience Institute; Nursing; Physical Therapy and Rehabilitation Science; Neuroscience and Pharmacology
Record Identifier: 9984230623602771

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