A Review of Select Centralized Pain Syndromes Relationship With Childhood Sexual Abuse, Opiate Prescribing, and Treatment Implications for the Primary Care Physician

• Published in: Health services research and managerial epidemiology Vol. 2; p. 2333392814567920
• Main Authors: Spiegel, David R., Chatterjee, Aparna, McCroskey, Aidan L., Ahmadi, Tamana, Simmelink, Drew, Oldfield, Edward C., Pryor, Christopher R., Faschan, Michael, Raulli, Olivia
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2015
• Subjects: Systematic Review; opiate misuse; serotonin–norepinephrine reuptake inhibitors; childhood sexual trauma; centralized pain syndromes; anticonvulsants
• ISSN: 2333-3928; 2333-3928
• DOI: 10.1177/2333392814567920

Pain can be broadly divided into 3 classes, including nociceptive or inflammatory pain (protective), neuropathic (pathological, occurring after damage to the nervous system), or centralized (pathological, due to abnormal function but with no damage or inflammation to the nervous system). The latter has been posited to occur when descending analgesic pathways are attenuated and/or glutamatergic transmission is facilitated. Additionally, this “pain prone phenotype” can be associated with early life trauma and a suboptimal response to opiates. This article will review the relationships between centralized pain syndromes (ie, fibromyalgia, chronic low back pain), childhood sexual abuse, and opiate misuse. Finally, treatment implications, potentially effecting primary care physicians, will be discussed.