Chronic secondary musculoskeletal pain from persistent inflammation

Definition

Chronic secondary musculoskeletal pain from persistent inflammation is chronic pain due to inflammatory mechanisms in joint(s), bone(s), tendon(s) or vertebral column. The pain may be spontaneous or movement-induced. It is characterized by clinical features of inflammation, including increased sensitivity of the part to stimuli. Chronic secondary musculoskeletal pain from persistent inflammation is most common in rheumatological conditions where chronic pain is the main symptom, and where inflammation is the primary pathophysiological mechanism. Chronic secondary musculokeletal pain is one of the most frequent symptoms in auto-immune and auto-inflammatory disorders, mostly driven by systemic or local inflammation. Classification of chronic secondary musculoskeletal pain from persistent inflammation is linked to the classification of rheumatological disorders, where inflammation is the main pathophysiological mechanism. Inflammation has several determinants and chronic pain related to inflammation can be divided in 3 main sub-categories: -auto-immune and auto-inflammatory disorders -crystal deposition diseases -infection Diagnostic Criteria: Conditions A to C are fulfilled: A. Chronic pain (persistent or recurrent for longer than 3 months) in joint(s), bone(s), tendon(s) or vertebral column is present. The pain may be spontaneous or movement induced. B. At least one of B1 to B3 is fulfilled: B.1 Systemic inflammatory illness is present. B.2 Local signs of inflammation are present. B.3 Raised laboratory markers of inflammation are present. C. The pain is not better accounted for by another diagnosis of chronic pain.

Inclusions

• Chronic secondary musculoskeletal pain from persistent inflammation due to infection
• Chronic secondary musculoskeletal pain from persistent inflammation due to crystal deposition
• Chronic secondary musculoskeletal pain from persistent inflammation due to autoimmune and auto-inflammatory disorders

Index Terms