Open AccessCancer pain: A critical review of mechanism-based classification and physical therapy management in palliative care
Author(s) -
Senthil P Kumar
Publication year - 2011
Publication title -
indian journal of palliative care/indian journal of palliative care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.395
H-Index - 26
eISSN - 1998-3735
pISSN - 0973-1075
DOI - 10.4103/0973-1075.84532
Subject(s) - medicine , biopsychosocial model , mechanism (biology) , palliative care , cancer pain , central sensitization , cancer , physical therapy , manual therapy , intensive care medicine , nociception , alternative medicine , psychiatry , nursing , philosophy , receptor , epistemology , pathology
Mechanism-based classification and physical therapy management of pain is essential to effectively manage painful symptoms in patients attending palliative care. The objective of this review is to provide a detailed review of mechanism-based classification and physical therapy management of patients with cancer pain. Cancer pain can be classified based upon pain symptoms, pain mechanisms and pain syndromes. Classification based upon mechanisms not only addresses the underlying pathophysiology but also provides us with an understanding behind patient's symptoms and treatment responses. Existing evidence suggests that the five mechanisms - central sensitization, peripheral sensitization, sympathetically maintained pain, nociceptive and cognitive-affective - operate in patients with cancer pain. Summary of studies showing evidence for physical therapy treatment methods for cancer pain follows with suggested therapeutic implications. Effective palliative physical therapy care using a mechanism-based classification model should be tailored to suit each patient's findings, using a biopsychosocial model of pain.