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12 - Chronic pain in pregnancy

from Section 3 - Nervous system disorders

Published online by Cambridge University Press:  19 October 2009

By
Hector J. Lacassie  and
Holly A. Muir
Edited by
David R. Gambling ,
M. Joanne Douglas  and
Robert S. F. McKay
Hector J. Lacassie
Affiliation:
Associate Professor, Anesthesiology Departament Pontificia Universidad Católica de Chile; Visiting Associate, Duke Univerity, Medical Center, Durham, NC, USA
Holly A. Muir
Affiliation:
Vice Chair, Clinical Operations, Department of Anesthesiology, Chief, Division of Women's Anesthesia, Duke University, Medical Center, Durham, North Carolina, USA
David R. Gambling
Affiliation:
University of California, San Diego
M. Joanne Douglas
Affiliation:
University of British Columbia, Vancouver
Robert S. F. McKay
Affiliation:
University of Kansas
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Summary

Introduction

Pain is defined as a sensory and emotional experience associated with actual tissue damage or described in terms of such damage. This definition has endured through time; however, the classification of the different types of pain is evolving. Original descriptions of pain were based on a temporal evolution, where the distinction between acute and chronic pain was that if it lasted for more than six months it was considered chronic. Another more conservative and innovative view proposed one month as the defining criterion. These early definitions did not account for the mechanisms involved in the development of the pain. The prevailing contemporary view is to classify pain according to the primary pathology involved in the cause of pain, namely: inflammatory (acute) or neuropathic (chronic). The latter can be considered a disease of the nervous system and not merely a symptom of some other condition. Furthermore, poorly treated acute pain can lead to neuropathic chronic pain. The current temporal cutoff value for chronic pain is three months.

During pregnancy, acute inflammatory pain, usually arising from labor and delivery, is the most common type of pain. However, other pain syndromes (chronic neuropathic or acute inflammatory evolving to chronic neuropathic) have been recognized throughout pregnancy. In this chapter we will discuss painful entities encountered during pregnancy, focusing on the chronic pain states and recurrent inflammatory pain that may lead to chronic pain.

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Obstetric Anesthesia and Uncommon Disorders , pp. 229 - 238
Publisher: Cambridge University Press
Print publication year: 2008

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  • Chronic pain in pregnancy
    • By Hector J. Lacassie, Associate Professor, Anesthesiology Departament Pontificia Universidad Católica de Chile; Visiting Associate, Duke Univerity, Medical Center, Durham, NC, USA, Holly A. Muir, Vice Chair, Clinical Operations, Department of Anesthesiology, Chief, Division of Women's Anesthesia, Duke University, Medical Center, Durham, North Carolina, USA
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book: Obstetric Anesthesia and Uncommon Disorders
  • Online publication: 19 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544552.013
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  • Chronic pain in pregnancy
    • By Hector J. Lacassie, Associate Professor, Anesthesiology Departament Pontificia Universidad Católica de Chile; Visiting Associate, Duke Univerity, Medical Center, Durham, NC, USA, Holly A. Muir, Vice Chair, Clinical Operations, Department of Anesthesiology, Chief, Division of Women's Anesthesia, Duke University, Medical Center, Durham, North Carolina, USA
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book: Obstetric Anesthesia and Uncommon Disorders
  • Online publication: 19 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544552.013
Available formats
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  • Chronic pain in pregnancy
    • By Hector J. Lacassie, Associate Professor, Anesthesiology Departament Pontificia Universidad Católica de Chile; Visiting Associate, Duke Univerity, Medical Center, Durham, NC, USA, Holly A. Muir, Vice Chair, Clinical Operations, Department of Anesthesiology, Chief, Division of Women's Anesthesia, Duke University, Medical Center, Durham, North Carolina, USA
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book: Obstetric Anesthesia and Uncommon Disorders
  • Online publication: 19 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544552.013
Available formats
×