Toward more focused multimodal and multidisciplinary approaches for pain management in Parkinson's disease

J Pain Res. 2019 Jul 22:12:2201-2209. doi: 10.2147/JPR.S209616. eCollection 2019.

Abstract

In Parkinson's disease (PD), pain represents a significant issue in terms of prevalence, clinical features, and treatment. Painful manifestations not strictly related to the disease are often amplified by the motor dysfunction. On the other hand, typical pain problems may specifically concern this vulnerable population. In turn, pain may have a deep impact on patients' health-related quality of life. However, pain treatment in PD remains an unmet need as only about half of patients with pain use analgesics and pain is often managed by simply increasing doses of PD medications. In this complex scenario, pain treatments should follow multimodal approaches through a careful combination of pharmacological agents with non-pharmacological strategies, depending on the type of pain and the clinical context. A multidisciplinary approach involving medical specialists from different disciplines could be a winning strategy to address the issue. This work is aimed to provide practical suggestions useful for different types of clinicians and care professionals for pain management in this vulnerable population.

Keywords: Parkinson disease; acetaminophen; non-steroidal anti-inflammatory agents; opioids; pain assessment; pain management.