Precision management of post-COVID pain: An evidence and clinical-based approach

dc.contributor.authorFernández-de-las-Peñas, César
dc.contributor.authorNijs, Jo
dc.contributor.authorGiordano, Rocco
dc.contributor.authorArendt-Nielsen, Lars
dc.date.accessioned2023-09-27T14:22:43Z
dc.date.available2023-09-27T14:22:43Z
dc.date.issued2023
dc.descriptionDanish National Research Foundation. Grant Number: DNRF121 Novo Nordisk Foundation. Grant Number: NNF21OC0067235es
dc.description.abstractBackgroundPain after a SARS-CoV-2 acute infection (post-COVID pain) is becoming a new healthcare emergency but remains underestimated and most likely undertreated due to a lack of recognition of the phenomenon and knowledge of the underlying pain mechanisms. Evidence supporting any particular treatment approach for the management of post-COVID pain is lacking. Large variability in the patient response to any standard pain treatments is clinically observed, which has led to calls for a personalized, tailored approach to treating patients with chronic post-COVID pain (i.e. ‘precision pain medicine’). Applying the global concerted action towards precision medicine to post-COVID pain could help guide clinical decision-making and aid in more effective treatments.MethodsThe current position paper discusses factors to be considered by clinicians for managing post-COVID pain ranging from identification of the pain phenotype to genetic consideration.ResultsThe ability of clinicians to phenotype post-COVID pain into nociceptive, neuropathic, nociplastic or mixed type is suggested as the first step to better planification of a treatment programme. Further, the consideration of other factors, such as gender, comorbidities, treatments received at the acute phase of infection for onset-associated COVID-19 symptoms, factors during hospitalization or the presence of emotional disturbances should be implemented into a treatment programme.ConclusionsAccordingly, considering these factors, management of post-COVID pain should include multimodal pharmacological and non-pharmacological modalities targeting emotional/cognitive aspects (i.e. psychological and/or coping strategies), central sensitization-associated mechanisms (i.e. pain neuroscience education), exercise programmes as well as lifestyle interventions (e.g. nutritional support and sleep management).SignificanceThis position paper presents an evidence-based clinical reasoning approach for precision management of post-COVID pain.es
dc.identifier.citationFernández-de-las-Peñas, C., Nijs, J., Giordano, R., & Arendt-Nielsen, L. (2023). Precision management of post-COVID pain: An evidence and clinical-based approach. European Journal of Pain, 27, 1107–1125. https://doi.org/10.1002/ejp.2095es
dc.identifier.doi10.1002/ejp.2095es
dc.identifier.issn1532-2149
dc.identifier.urihttps://hdl.handle.net/10115/24584
dc.language.isoenges
dc.publisherWileyes
dc.rightsAtribución 4.0 Internacional*
dc.rights.accessRightsinfo:eu-repo/semantics/openAccesses
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.titlePrecision management of post-COVID pain: An evidence and clinical-based approaches
dc.typeinfo:eu-repo/semantics/articlees

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