Algorithm of Pain Research

As it does not understand and is unable to treat many forms of chronic pain, modern medicine very frequently appears impotent. The situation is complicated by the fact that the problem of pain has always been and remains the core of clinical thought for doctors in all branches of medicine. The «pain component» has an invisible presence in all stages of patient diagnosis and treatment, whether the discussion concerns disorders of the internal organs, circulatory system or peripheral nervous system. In essence, this is a multidisciplinary problem, which like no other includes practically all branches of modern fundamental medicine. Therefore, only a systematic approach to the analysis of pain, one that encompasses the key issues of this problem, can provide a sufficiently clear and comprehensive picture of not only the substance of the phenomenon in question, but also of the mechanisms involved in its appearance and abatement.

Despite the fact that the aforementioned thesis has been postulated in medical literature for sufficiently long time, there nevertheless has yet to occur a serious restructuring of the views of specialists concerning this clinical event. The classification we have developed may be of practical assistance in ascertaining the nature of a pain syndrome. It can realistically be regarded as a kind of diagnostic algorithm for clinical studies for the purpose of acquiring information of the highest significance for the determination of the essence of a pain syndrome. The classification is a vade mecum for the study of patients with chronic pain. It makes possible a diagnostic search independent of the nature, localization, and clinical manifestations of chronic pain. Indicators reflecting the mechanisms of the origination and development of chronic pain at the "tissue" and "neural" levels are of fundamental significance in the recognition of the nature of algesic phenomena.

The determination of the nature of pain is a quite complex intellectual process that consists of a number of sequential stages. In this responsible and at times difficult process, the physician must adhere to a definite sequence and a clear plan. The elucidation of the following factors is of fundamental significance in the diagnostic search.

Basis for Establishing the Nature of Pain Syndrome 

It is difficult to overestimate the differentiation of the various forms and types of chronic pain (carried out in accordance with the principles of the Law of Tissue Specificity and Mutation of Mechanisms of Painful Phenomena) for the development of the principles of the individual approach to the rehabilitation of patients with chronic pain. Based on the foundation of the entire corpus of theoretical and practical knowledge, the contemporary model of chronic pain makes it possible to meaningfully (consciously) approach the elimination of algesic phenomena in the presence of the most diverse pathology of the body's organs and systems. The new knowledge is the "key" to the correct understanding and solution of the problems of pain applicably for all medical specialists. 

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