Fernández-de-las-Peñas, CésarNijs, JoGiordano, RoccoArendt-Nielsen, Lars2023-09-272023-09-272023Fernández-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.20951532-2149https://hdl.handle.net/10115/24584Danish National Research Foundation. Grant Number: DNRF121 Novo Nordisk Foundation. Grant Number: NNF21OC0067235BackgroundPain 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.engAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/article10.1002/ejp.2095info:eu-repo/semantics/openAccess