PDF herunterladen
CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(02): e160-e171
DOI: 10.1055/s-0043-1776135
Artigo de Atualização
Dor

Atualização no manejo da dor musculoesquelética

Artikel in mehreren Sprachen: português | English
André Wan Wen Tsai 
1   Colégio Médico de Acupuntura do Estado de SP, São Paulo, SP, Brasil
,
Ricardo Kobayashi
2   Centro de Dor, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Ibrahim Afrânio Willi Liu 
3   Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
,
Márcio Fim 
4   Cirurgia de Ombro e Cotovelo, Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Belo Horizonte, MG, Brasil
,
André Cicone Liggieri
2   Centro de Dor, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Edilson Silva Machado 
5   Serviço de Dor e Cuidados Paliativos, Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brasil
› Institutsangaben Suporte Financeiro Este estudo não recebeu nenhum suporte financeiro.
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Resumo

A dor é a queixa mais comum recebida pelo ortopedista no ambulatório e/ou emergência. Inúmeras publicações relatam o manejo inadequado tanto da dor aguda quanto da dor crônica pelos profissionais da saúde. O objetivo desse artigo de atualização é trazer informações sobre a dor musculoesquelética, sua classificação, avaliação, diagnóstico e abordagem terapêutica multimodal para cada situação. Desta maneira, nas dores agudas seu controle adequado possibilita um trabalho de reabilitação mais precoce, bem como diminui os índices de cronificação da dor. Nas dores crônicas sua abordagem além da diminuição de sua intensidade, visa também melhorar a qualidade de vida. Atualmente alguns procedimentos estão sendo cada vez mais utilizados com auxílio de aparato de imagem com objetivo diagnóstico e terapêutico.

Palavras-chave

dor aguda - dor crônica - dor musculoesquelética - manejo da dor - dor pós-operatória


Publikationsverlauf

Eingereicht: 29. April 2020

Angenommen: 25. August 2023

Artikel online veröffentlicht:
01. Februar 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Rice ASC, Smith BH, Blyth FM. Pain and the global burden of disease. Pain 2016; 157 (04) 791-796
    CrossrefPubMedGoogle Scholar
  • 2 Henschke N, Kamper SJ, Maher CG. The epidemiology and economic consequences of pain. Mayo Clin Proc 2015; 90 (01) 139-147
    CrossrefPubMedGoogle Scholar
  • 3 Raja SN, Carr DB, Cohen M. et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain 2020; 161 (09) 1976-1982
    CrossrefPubMedGoogle Scholar
  • 4 Chapman CR, Vierck CJ. The Transition of Acute Postoperative Pain to Chronic Pain: An Integrative Overview of Research on Mechanisms. J Pain 2017; 18 (04) 359.e1-359.e38
    CrossrefPubMedGoogle Scholar
  • 5 Woller SA, Eddinger KA, Corr M, Yaksh TL. An overview of pathways encoding nociception. Clin Exp Rheumatol 2017; 35 (5, Suppl 107) 40-46
    PubMedGoogle Scholar
  • 6 Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet 2021; 397 (10289): 2082-2097
    CrossrefPubMedGoogle Scholar
  • 7 Aguiar DP, Souza CP, Barbosa WJ, Santos-Júnior FF, Oliveira AS. Prevalência de dor crônica no Brasil: revisão sistemática. BrJP São Paulo 2021; 4 (03) 257-267
    Google Scholar
  • 8 Fletcher D, Stamer UM, Pogatzki-Zahn E. et al; euCPSP group for the Clinical Trial Network group of the European Society of Anaesthesiology. Chronic postsurgical pain in Europe: An observational study. Eur J Anaesthesiol 2015; 32 (10) 725-734
    CrossrefPubMedGoogle Scholar
  • 9 Treede RD, Rief W, Barke A. et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 2019; 160 (01) 19-27
    CrossrefPubMedGoogle Scholar
  • 10 Chou R, Gordon DB, de Leon-Casasola OA. et al. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain 2016; 17 (02) 131-157
    CrossrefPubMedGoogle Scholar
  • 11 Merskey H, Bogduk N. , Eds. Classification of chronic pain descriptions of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle (WA): International Association for the Study of Pain; 1994
    Google Scholar
  • 12 Moisset X, Bouhassira D, Avez Couturier J. et al. Pharmacological and non-pharmacological treatments for neuropathic pain: Systematic review and French recommendations. Rev Neurol (Paris) 2020; 176 (05) 325-352
    CrossrefPubMedGoogle Scholar
  • 13 Heller GZ, Manuguerra M, Chow R. How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand J Pain 2016; 13: 67-75
    CrossrefPubMedGoogle Scholar
  • 14 VanDenKerkhof EG, Stitt L, Clark AJ. et al. Sensitivity of the DN4 in Screening for Neuropathic Pain Syndromes. Clin J Pain 2018; 34 (01) 30-36
    CrossrefPubMedGoogle Scholar
  • 15 Bennett M. The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs. Pain 2001; 92 (1-2): 147-157
    CrossrefPubMedGoogle Scholar
  • 16 Freynhagen R, Baron R, Gockel U, Tölle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 2006; 22 (10) 1911-1920
    CrossrefPubMedGoogle Scholar
  • 17 World Health Organization. Cancer pain relief. Geneva Albany, NY: World Health Organization; ; WHO Publications Center USA distributor; 1986
    Google Scholar
  • 18 Yang J, Bauer BA, Wahner-Roedler DL, Chon TY, Xiao L. The Modified WHO Analgesic Ladder: Is It Appropriate for Chronic Non-Cancer Pain?. J Pain Res 2020; 13: 411-417
    CrossrefPubMedGoogle Scholar
  • 19 Crews JC. Multimodal pain management strategies for office-based and ambulatory procedures. JAMA 2002; 288 (05) 629-632
    CrossrefPubMedGoogle Scholar
  • 20 Rezende RM, França DS, Menezes GB, dos Reis WG, Bakhle YS, Francischi JN. Different mechanisms underlie the analgesic actions of paracetamol and dipyrone in a rat model of inflammatory pain. Br J Pharmacol 2008; 153 (04) 760-768
    CrossrefPubMedGoogle Scholar
  • 21 Lorenzetti BB, Ferreira SH. Mode of analgesic action of dipyrone: direct antagonism of inflammatory hyperalgesia. Eur J Pharmacol 1985; 114 (03) 375-381
    CrossrefPubMedGoogle Scholar
  • 22 Bernal W, Auzinger G, Dhawan A, Wendon J. Acute liver failure. Lancet 2010; 376 (9736) 190-201
    CrossrefPubMedGoogle Scholar
  • 23 Hamerschlak N, Maluf E, Biasi Cavalcanti A. et al. Incidence and risk factors for agranulocytosis in Latin American countries–the Latin Study: a multicenter study. Eur J Clin Pharmacol 2008; 64 (09) 921-929
    CrossrefPubMedGoogle Scholar
  • 24 Sakata RK, Nunes MHG. Analgesics use for kidney failure. Rev Dor 2014; 15 (03) 224-229
    CrossrefGoogle Scholar
  • 25 Schug SA. Clinical pharmacology of non-opioid and opioid analgesics. In: Justins DM. , editor. Pain 2005–An Up- date Review: Refresher Course Syllabus. Seattle: IASP Press; 2005: 31-40
    Google Scholar
  • 26 Whelton A. Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med 1999; 106 (5B): 13S-24S
    CrossrefPubMedGoogle Scholar
  • 27 Busse JW, Wang L, Kamaleldin M. et al. Opioids for Chronic Noncancer Pain: A Systematic Review and Meta-analysis. JAMA 2018; 320 (23) 2448-2460
    CrossrefPubMedGoogle Scholar
  • 28 Kraychete DC, Siqueira JTT, Zakka TRM, Garcia JBS. Recommendations for the use of opioids in Brazil: Part III. Use in special situations (postoperative pain, musculoskeletal pain, neuropathic pain, gestation and lactation). Rev Dor 2014; 15 (02) 126-132
    CrossrefGoogle Scholar
  • 29 Kraychete DC, Sakata RK. Use and rotation of opioids in chronic non-oncologic pain. Rev Bras Anestesiol 2012; 62 (04) 554-562
    CrossrefPubMedGoogle Scholar
  • 30 Kraychete DC, Garcia JBS, Siqueira JTT. Recommendations for the use of opioids in Brazil: Part IV. Adverse opioid effects. Rev Dor 2014; 15 (03) 215-223
    CrossrefGoogle Scholar
  • 31 García CA, Santos Garcia JB, Rosario Berenguel Cook MD. et al. Undertreatment of pain and low use of opioids in Latin America. Pain Manag (Lond) 2018; 8 (03) 181-196
    CrossrefPubMedGoogle Scholar
  • 32 Lee CR, McTavish D, Sorkin EM. Tramadol. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in acute and chronic pain states. Drugs 1993; 46 (02) 313-340
    PubMedGoogle Scholar
  • 33 King S, Forbes K, Hanks GW, Ferro CJ, Chambers EJ. A systematic review of the use of opioid medication for those with moderate to severe cancer pain and renal impairment: a European Palliative Care Research Collaborative opioid guidelines project. Palliat Med 2011; 25 (05) 525-552
    CrossrefPubMedGoogle Scholar
  • 34 Vree TB, van Dongen RT, Koopman-Kimenai PM. Codeine analgesia is due to codeine-6-glucuronide, not morphine. Int J Clin Pract 2000; 54 (06) 395-398
    CrossrefPubMedGoogle Scholar
  • 35 Gong QL, Hedner T, Hedner J, Björkman R, Nordberg G. Antinociceptive and ventilatory effects of the morphine metabolites: morphine-6-glucuronide and morphine-3-glucuronide. Eur J Pharmacol 1991; 193 (01) 47-56
    CrossrefPubMedGoogle Scholar
  • 36 Kobayashi R, Luzo MVM, Cohen M. Tratado de dor musculoesquelética. São Paulo: Alef; 2019
    Google Scholar
  • 37 Lalovic B, Kharasch E, Hoffer C, Risler L, Liu-Chen LY, Shen DD. Pharmacokinetics and pharmacodynamics of oral oxycodone in healthy human subjects: role of circulating active metabolites. Clin Pharmacol Ther 2006; 79 (05) 461-479
    CrossrefPubMedGoogle Scholar
  • 38 Dalal S, Chitneni A, Berger AA. et al. Buprenorphine for chronic pain: A safer alternative to traditional opioids. Health Psychol Res 2021; 9 (01) 27241
    CrossrefPubMedGoogle Scholar
  • 39 Alshehri FS. Tapentadol: A review of experimental pharmacology studies, clinical trials, and recent findings. Drug Des Devel Ther 2023; 17: 851-861
    CrossrefPubMedGoogle Scholar
  • 40 Abdel Shaheed C, Maher CG, Williams KA, McLachlan AJ. Efficacy and tolerability of muscle relaxants for low back pain: Systematic review and meta-analysis. Eur J Pain 2017; 21 (02) 228-237
    CrossrefPubMedGoogle Scholar
  • 41 van Tulder MW, Touray T, Furlan AD, Solway S, Bouter LM. Muscle relaxants for non-specific low back pain. Cochrane Database Syst Rev 2003; 2003 (02) CD004252
    PubMedGoogle Scholar
  • 42 Finnerup NB, Attal N, Haroutounian S. et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol 2015; 14 (02) 162-173
    CrossrefPubMedGoogle Scholar
  • 43 Attal N. Pharmacological treatments of neuropathic pain: The latest recommendations. Rev Neurol (Paris) 2019; 175 (1-2): 46-50
    CrossrefPubMedGoogle Scholar
  • 44 Hainline B, Derman W, Vernec A. et al. International Olympic Committee consensus statement on pain management in elite athletes. [published correction appears in Br J Sports Med. 2018 Jan 3;] Br J Sports Med 2017; 51 (17) 1245-1258
    CrossrefPubMedGoogle Scholar
  • 45 Sabatschus I, Bösl I, Prevoo M. et al. Comparative Benefit-Risk Assessment for Lidocaine 700 mg Medicated Plaster and Pregabalin in Peripheral Neuropathic Pain Following a Structured Framework Approach. Pain Ther 2022; 11 (01) 73-91
    CrossrefPubMedGoogle Scholar
  • 46 Menezes MS, Sakata RK, Issy AM. Anticonvulsivantes. In: Sakata RK, Issy AM. , editores. Fármacos para tratamento da dor. Barueri, SP: Manole; 2008: 111-138
    Google Scholar
  • 47 Ben-Menachem E. Pregabalin pharmacology and its relevance to clinical practice. Epilepsia 2004; 45 (Suppl. 06) 13-18
    CrossrefPubMedGoogle Scholar
  • 48 Gammaitoni AR, Alvarez NA, Galer BS. Pharmacokinetics and safety of continuously applied lidocaine patches 5%. Am J Health Syst Pharm 2002; 59 (22) 2215-2220
    CrossrefPubMedGoogle Scholar
  • 49 Überall MA, Eerdekens M, Hollanders E, Bösl I, Sabatschus I. Lidocaine 700 mg medicated plaster for postherpetic neuralgia: real-world data from the German Pain e-Registry. Pain Manag (Lond) 2022; 12 (02) 195-209
    CrossrefPubMedGoogle Scholar
  • 50 Derry S, Wiffen PJ, Kalso EA. et al. Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews. Cochrane Database Syst Rev 2017; 5 (05) CD008609
    PubMedGoogle Scholar
  • 51 Bannuru RR, Osani MC, Vaysbrot EE. et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage 2019; 27 (11) 1578-1589
    CrossrefPubMedGoogle Scholar
  • 52 Liggieri VC, Yeng LT, Teixeira MJ. , Eds. Tratado de dor, reabilitação e atividade física: Conceitos e prática clínica. São Paulo: Editora dos Editores; 2022
    CrossrefGoogle Scholar
  • 53 Centeno CJ, Williams CJ, Hyzy M. Interventional orthopedics in pain medicine practice. Tech Reg Anesth Main Manag 2015; 19 (1–2): 26-31
    Google Scholar
  • 54 Braun L, Braun L. Técnicas intervencionistas no tratamento da dor. Cienc Cult 2011; 63 (01) 49-50
    CrossrefGoogle Scholar
  • 55 Korbe S, Udoji EN, Ness TJ, Udoji MA. Ultrasound-guided interventional procedures for chronic pain management. Pain Manag (Lond) 2015; 5 (06) 465-482
    PubMedGoogle Scholar
  • 56 Lin J. Platelet-rich plasma injection in the treatment of frozen shoulder: A randomized controlled trial with 6-month follow-up
. Int J Clin Pharmacol Ther 2018; 56 (08) 366-371
    CrossrefPubMedGoogle Scholar
  • 57 McCormick ZL, Reddy R, Korn M. et al. A prospective randomized trial of prognostic genicular nerve blocks to determine the predictive value for the outcome of cooled radiofrequency ablation for chronic knee pain due to osteoarthritis. Pain Med 2018; 19 (08) 1628-1638
    CrossrefPubMedGoogle Scholar