The IASP classification of chronic pain for ICD-11: Chronic neuropathic pain

Joachim Scholz, Nanna B. Finnerup, Nadine Attal, Qasim Aziz, Ralf Baron, Michael I. Bennett, Rafael Benoliel, Milton Cohen, Giorgio Cruccu, Karen D. Davis, Stefan Evers, Michael First, Maria Adele Giamberardino, Per Hansson, Stein Kaasa, Beatrice Korwisi, Eva Kosek, Patricia Lavand'Homme, Michael Nicholas, Turo NurmikkoSerge Perrot, Srinivasa N. Raja, Andrew S.C. Rice, Michael C. Rowbotham, Stephan Schug, David M. Simpson, Blair H. Smith, Peter Svensson, Johan W.S. Vlaeyen, Shuu Jiun Wang, Antonia Barke, Winfried Rief, Rolf Detlef Treede*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

617 Scopus citations

Abstract

The upcoming 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) of the World Health Organization (WHO) offers a unique opportunity to improve the representation of painful disorders. For this purpose, the International Association for the Study of Pain (IASP) has convened an interdisciplinary task force of pain specialists. Here, we present the case for a reclassification of nervous system lesions or diseases associated with persistent or recurrent pain for ≥3 months. The new classification lists the most common conditions of peripheral neuropathic pain: trigeminal neuralgia, peripheral nerve injury, painful polyneuropathy, postherpetic neuralgia, and painful radiculopathy. Conditions of central neuropathic pain include pain caused by spinal cord or brain injury, poststroke pain, and pain associated with multiple sclerosis. Diseases not explicitly mentioned in the classification are captured in residual categories of ICD-11. Conditions of chronic neuropathic pain are either insufficiently defined or missing in the current version of the ICD, despite their prevalence and clinical importance. We provide the short definitions of diagnostic entities for which we submitted more detailed content models to the WHO. Definitions and content models were established in collaboration with the Classification Committee of the IASP's Neuropathic Pain Special Interest Group (NeuPSIG). Up to 10% of the general population experience neuropathic pain. The majority of these patients do not receive satisfactory relief with existing treatments. A precise classification of chronic neuropathic pain in ICD-11 is necessary to document this public health need and the therapeutic challenges related to chronic neuropathic pain.

Original languageEnglish
Pages (from-to)53-59
Number of pages7
JournalPain
Volume160
Issue number1
DOIs
StatePublished - 1 Jan 2019

Keywords

  • Chronic pain
  • Classification
  • Diagnosis
  • ICD-11
  • Neuropathic pain
  • WHO

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