AccScience Publishing / GTM / Volume 2 / Issue 2 / DOI: 10.36922/gtm.312
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ORIGINAL RESEARCH ARTICLE

New insights into chronic pain management based on biopsychosocial model

Ekaterina Fedorovna Turovskaia1* ,  Lyudmila Ivanovna Alekseeva1*
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1 Federal State Budgetary Institution Research Institute of Rheumatology, V. A. Nasonova of R. A. M. S. Moscown Federation, Kashirskoe Shosse 34 A, Russia
Global Translational Medicine 2023, 2(2), 312 https://doi.org/10.36922/gtm.312
Submitted: 23 December 2022 | Accepted: 5 April 2023 | Published: 19 April 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The biopsychosocial model of pain dominates the scientific community’s understanding of chronic pain. Chronic pain is considered a different form of depression. In this study, pain relief was explored in chronic pain patients with different neurological disease, accompanied by comorbid symptoms, depression, and insomnia. Twenty-three chronic pain patients aged 26–79 years with comorbid symptoms were included in a prospective 12-week treatment using 10 mg vortioxetine. Different types of chronic pain were represented in this study: low back pain (13 patients), headache (four patients); neuropathic mechanism-induced pain (six patients) – spinal stenosis (two patients), radiculopathy (two patients), and trigeminal neuralgia (two patients). Efficacy of vortioxetine treatment was monitored after 1 week, 3 weeks, and 12 weeks. Visual analog scale (VAS) was used for pain intensity value. Dynamic of pain relief was assessed in accordance with comorbid depression and insomnia. Most patients with chronic pain actively reported depression (65%) and insomnia (74%). Depression was statistically rare in patients with neuropathic pain (33%) compared to patients with nociceptive pain (82%; P < 0.05). Incidence of insomnia was lower, although not statistically, in patients with neuropathic mechanism-induced pain (50%) compared to patients with nociceptive pain (82%, P = 0.129). Patients younger than 65 years reported pain reduction, according to VAS, after 1 week and 3 weeks vortioxetine therapy. The mean pain relief was 1.1 cm in young patients versus 0.16 cm in patients aged >65 years (P < 0.01) after 1-week treatment, and it was 2.35 cm in young patients versus 1.7 cm in patients aged >65 years (P < 0.05) after 3-week treatment. Vortioxetine therapy was effective in different types of chronic pain, accompanied by comorbid depression and insomnia. At early stage of treatment, pain relief was lower in old patients aged >65 years. Regardless of age, all patients had significant pain relief after the 12-week treatment.

Keywords
Chronic pain
Biopsychosocial model
Chronic pain management
Funding
None.
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Conflict of interest
The authors declared no conflicts of interest.
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Global Translational Medicine, Electronic ISSN: 2811-0021 Published by AccScience Publishing
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