TY - JOUR
T1 - Breakthrough pain in malignant and non-malignant diseases
T2 - a review of prevalence, characteristics and mechanisms
AU - Svendsen, Kristina B
AU - Andersen, Steen
AU - Arnason, Sigurdur
AU - Arner, Staffan
AU - Breivik, Harald
AU - Heiskanen, Tarja
AU - Kalso, Eija
AU - Kongsgaard, Ulf E
AU - Sjogren, Per
AU - Strang, Peter
AU - Bach, Flemming W
AU - Jensen, Troels S
PY - 2005
Y1 - 2005
N2 - Breakthrough pain or transient worsening of pain in patients with an ongoing steady pain is a well known feature in cancer pain patients, but it is also seen in non-malignant pain conditions with involvement of nerves, muscles, bones or viscera. Continuous and intermittent pain seems to be a general feature of these different pain conditions, and this raises the possibility of one or several common mechanisms underlying breakthrough pain in malignant and non-malignant disorders. Although the mechanisms of spontaneous ongoing pain and intermittent flares of pain (BTP) may be difficult to separate, we suggest that peripheral and/or central sensitization (hyperexcitability) may play a major role in many causes of BTP. Mechanical stimuli (e.g. micro-fractures) changes in chemical environments and release of tumour growth factors may initiate sensitization both peripherally and centrally. It is suggested that sensitization could be the common denominator of BTP in malignant and non-malignant pain. (c) 2004 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.
AB - Breakthrough pain or transient worsening of pain in patients with an ongoing steady pain is a well known feature in cancer pain patients, but it is also seen in non-malignant pain conditions with involvement of nerves, muscles, bones or viscera. Continuous and intermittent pain seems to be a general feature of these different pain conditions, and this raises the possibility of one or several common mechanisms underlying breakthrough pain in malignant and non-malignant disorders. Although the mechanisms of spontaneous ongoing pain and intermittent flares of pain (BTP) may be difficult to separate, we suggest that peripheral and/or central sensitization (hyperexcitability) may play a major role in many causes of BTP. Mechanical stimuli (e.g. micro-fractures) changes in chemical environments and release of tumour growth factors may initiate sensitization both peripherally and centrally. It is suggested that sensitization could be the common denominator of BTP in malignant and non-malignant pain. (c) 2004 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.
U2 - 10.1016/j.ejpain.2004.06.001
DO - 10.1016/j.ejpain.2004.06.001
M3 - Review Article
SN - 1090-3801
VL - 9
SP - 195
EP - 206
JO - European Journal of Pain
JF - European Journal of Pain
ER -