Pain management should ideally measure symptoms and treat pain mechanisms. But the identification of the underlying mechanisms is difficult as symptoms are not always equivalent to the mechanism.1
Usually, pain patients are analyzed on the basis of common causes of disease. This approach groups patients into categories, e.g. (low) back pain or osteoarthritic pain. Although such an approach is helpful, it ignores the possibility that diverse mechanisms may underlie the pain.Mechanism-based pain diagnosis can be difficult, but physicians should attempt to define the types of pain that the patient is experiencing:
- Pain related to inflammatory conditions
- Pain with no clear stimulus or associated damage
- Woolf CJ, Max MB. Mechanism-based pain diagnosis: issues for analgesic drug development. Anesthesiology. 2001;95:241-9.