Pain in amyotrophic lateral sclerosis: a narrative review

被引:9
作者
Kwak, Soyoung [1 ]
机构
[1] Yeungnam Univ, Coll Med, Dept Phys Med & Rehabil, 170 Hyeonchung Ro, Daegu 42415, South Korea
来源
JOURNAL OF YEUNGNAM MEDICAL SCIENCE | 2022年 / 39卷 / 03期
关键词
Amyotrophic lateral sclerosis; Motor neuron disease; Non -motor symptoms; Pain; Palliative care;
D O I
10.12701/jyms.2022.00332
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.
引用
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页码:181 / 189
页数:9
相关论文
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Anekar A. A., 2022, WHO ANALGESIC LADDER