小结
定义
急性疼痛是损伤或疾病的常见后果，一般在起病后不久减轻，并在完全愈合后消退。由于康复时间最长不超过 3 个月，持续超过 3 个月的疼痛即被视为慢性疼痛或顽固性疼痛。患有持续性退行性疾病（例如类风湿性关节炎）或其他慢性病症（如偏头痛或神经病理性疼痛）的患者也可能出现慢性疼痛。神经病理性疼痛以触诱发痛和痛觉过敏为特点。触诱发痛是将无害刺激感知为疼痛。在痛觉过敏中，有害刺激产生的疼痛被放大或延长。在慢性疼痛患者中，疼痛严重度可能波动，疼痛增强或疼痛的急性发作可能和活动或应激增加相关，或隐匿性发生。慢性疼痛因神经性疼痛通路持续性激活和肌肉痉挛而发生。本文将慢性疼痛作为综合征讨论，囊括了无局部性或区域性病因的非恶性病症（例如腹痛或盆腔疼痛）。
[Figure caption and citation for the preceding image starts]: 急性疼痛随外伤或疾病发生，在愈合期间减弱，并在3个月内消退。在愈合完成后，由于神经性疼痛通路持续性激活和肌肉痉挛，慢性疼痛持续存在来自Marcus DA. Headache and chronic pain syndromes. The case-based guide to targeted assessment and treatment. Totowa, NJ: Humana Press; 2007 [Citation ends].
病史和查体
诊断性检查
治疗流程
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Consultant, Pain Medicine and Anaesthesia
North Bristol NHS Trust
Bristol
UK
利益冲突披露
GC has been sponsored by Boston Scientific, St Jude Medical, and Nevro to attend cadaveric workshops relevant to neuromodulation.Dr Gaurav Chhabra would like to gratefully acknowledge Dr Sarah Love-Jones and Dr Dawn A. Marcus, previous contributors to this monograph. SLJ has received consultancy fees for Boston Scientific and Nevro Corporation (regarding spinal cord stimulation) and is an Elected Council member of the British Pain Society. DAM is an author of a reference cited in this monograph.
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Clinical Instructor
Department of Anesthesiology
University of Washington School of Medicine
Seattle
WA
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JDS declares that he has no competing interests.Consultant in Pain Management
Pain Unit
King's College Hospital
London
UK
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JH has chaired advisory boards for Napp Pharmaceuticals Ltd., chaired a symposium, is a principle investigator and has participated in advisory boards for Grunenthal Ltd., and has given lectures for Pfizer Ltd. JH has also attended the American Pain Society meeting in 2009 sponsored by Grunenthal.Consultant in Pain Medicine
Pain Management Service
University Hospitals of Leicester
Leicester
UK
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