Dr Wayne Kampers | Harley Street Psychiatrist | Private Harley Psychiatrist | Harley Street Psychiatry

Chronic Pain has been Reclassified in the ICD-11

This became effective on in January 2022 after a creative collaboration between World the Health Organization (WHO) and the International Association for the Study of Pain (IASP).

The new system provides a single diagnostic code for chronic pain (MG30.0 Chronic primary pain).

Under the ICD-11 pain is not only recognized as a health condition on its own but it is also recognized as a symptom that can be secondary to other underlying health issues.

Under the new classification Chronic pain defined as Primary ( pain that persists or recurs for more than 3 months - as it had been previously) or secondary to organic causes.

The new definition of chronic primary pain is an important step forward and is neutral concerning the historical misleading dichotomy between somatic vs mental disorders.

It Includes important components of emotional distress and functional disability.

The diagnostic entities are listed according to the seven main categories of chronic pain:

Chronic primary pain

Chronic Secondary Pain

• Chronic cancer-related pain - secondary
  
• Chronic postsurgical and chronic post-traumatic pain - secondary
  
• Chronic neuropathic pain - secondary
  
• Chronic secondary headache or orofacial pain
  
• Chronic secondary visceral pain
  
• Chronic secondary musculoskeletal pain
  

Chronic primary pain categories:

1. Chronic widespread pain
2. Chronic primary headache or orofacial pain
3. Chronic primary visceral pain
4. Chronic primary musculoskeletal pain


Chronic widespread pain

• Fibromyalgia
  
• Complex regional pain syndrome
  
  • (CRPS) CRPS Type 1
    
  • CRPS Type 2
    

Chronic primary headache or orofacial pain

• Chronic migraine
  
• Chronic tension-type headache
  
• Trigeminal autonomic cephalalgias (TACs)
  
• Chronic primary temporomandibular disorder pains
  
• Burning mouth syndrome
  
• Chronic primary orofacial pain
  

Chronic primary visceral pain

• Chronic primary chest pain syndrome
  
• Chronic primary epigastric pain syndrome
  
• Irritable bowel syndrome
  
• Chronic primary abdominal pain syndrome
  
• Chronic primary bladder pain syndrome
  
• Chronic primary pelvic pain syndrome
  
• Chronic pelvic pain in females
  
• Chronic pelvic pain in males
  

Chronic primary musculoskeletal pain

• Chronic primary low back pain
  
• Chronic primary cervical pain
  
• Chronic primary thoracic pain
  
• Chronic primary limb pain
  

Chronic primary pain also has additional specifiers:

Pain severity

• 0 - 10
  
  • No pain
    
  • Worst pain imaginable
    

Pain-related distress

• Distress Thermometer used.
  
• Multifactorial unpleasant emotional experience
  
• Cognitive
  
• Behavioural
  
• Emotional
  
• Social
  
• Spiritual nature
  

Pain-related interference (disability)

• ADLs interference (Activities of Daily Living)
  
  • Mild
    
  • Moderate
    
  • Severe
    

Temporal characteristics of the pain (Course)

• Continuous
  
  • The pain is always present
    
• Episodic recurrent
  
  • There are recurrent pain attacks
    
  • With pain-free intervals
    
• Continuous with pain attack
  
  • There are recurrent pain attacks
    
  • As exacerbations of underlying continuous pain
    

Presence of psychosocial factors:

• Cognitive
  
  • Excessive worry
    
• Emotional
  
  • Fear
    
  • Anger
    
• Behavioural
  
  • Avoidance
    
• Social factors influenced:
  
  • Work
    
  • Relationships
    

Chronic pain results in negative psychobehavioral consequences such as:

• Demoralisation
  
• Hopelessness
  
• Avoidance
  
• Withdrawal
  

This new development has made it easier to design better Pain Recovery Programs, like our online The Pain Recovery Program and our residential White River Manor Pain Recovery Program