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Global Translational Medicine

ORIGINAL RESEARCH ARTICLE
New insights into chronic pain management

based on biopsychosocial model

Ekaterina Fedorovna Turovskaia* and Lyudmila Ivanovna Alekseeva*
Federal State Budgetary Institution Research Institute of Rheumatology, V. A. Nasonova of R. A. M.
S. Moscow, Russian Federation, Kashirskoe Shosse 34 A, Russia

Abstract

The biopsychosocial model of pain dominates the scientific community’s
understanding of chronic pain. Chronic pain is considered a different form of
depression. In this study, pain relief was explored in chronic pain patients with
different neurological disease, accompanied by comorbid symptoms, depression,
and insomnia. Twenty-three chronic pain patients aged 26–79 years with comorbid
symptoms were included in a prospective 12-week treatment using 10 mg
vortioxetine. Different types of chronic pain were represented in this study: low
back pain (13 patients), headache (four patients); neuropathic mechanism-induced
pain (six patients) – spinal stenosis (two patients), radiculopathy (two patients), and
trigeminal neuralgia (two patients). Efficacy of vortioxetine treatment was monitored
after 1 week, 3 weeks, and 12 weeks. Visual analog scale (VAS) was used for pain
intensity value. Dynamic of pain relief was assessed in accordance with comorbid
depression and insomnia. Most patients with chronic pain actively reported
depression (65%) and insomnia (74%). Depression was statistically rare in patients
*Corresponding author: with neuropathic pain (33%) compared to patients with nociceptive pain (82%;
Ekaterina Fedorovna Turovskaia P < 0.05). Incidence of insomnia was lower, although not statistically, in patients with
(katetur@yandex.ru)
Lyudmila Ivanovna Alekseeva neuropathic mechanism-induced pain (50%) compared to patients with nociceptive
(dr.alekseeva@gmail.com) pain (82%, P = 0.129). Patients younger than 65 years reported pain reduction,
Citation: Turovskaia EF, according to VAS, after 1 week and 3 weeks vortioxetine therapy. The mean pain relief
Alekseeva LI, 2023, New insights was 1.1 cm in young patients versus 0.16 cm in patients aged >65 years (P < 0.01)
into chronic pain management after 1-week treatment, and it was 2.35 cm in young patients versus 1.7 cm in
based on biopsychosocial model.
Global Transl Med, 2(2): 312. patients aged >65 years (P < 0.05) after 3-week treatment. Vortioxetine therapy was
https://doi.org/10.36922/gtm.312 effective in different types of chronic pain, accompanied by comorbid depression
Received: December 23, 2022 and insomnia. At early stage of treatment, pain relief was lower in old patients aged
Accepted: April 5, 2023 >65 years. Regardless of age, all patients had significant pain relief after the 12-week
Published Online: April 19, 2023 treatment.
Copyright: © 2023 Author(s).
This is an Open Access article
distributed under the terms of the Keywords: Chronic pain; Biopsychosocial model; Chronic pain management
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited. 1. Introduction
Publisher’s Note: AccScience Chronic pain is a common, complex, and distressing problem, which has a significant
Publishing remains neutral with impact on society and individuals . International Association for the Study of Pain
[1]
regard to jurisdictional claims in
published maps and institutional characterizes chronic pain as “pain which has persisted beyond normal tissue healing
[2]
affiliations. time” in the absence of other factors, and a condition lasting more than 3 months .

Volume 2 Issue 2 (2023) 1 https://doi.org/10.36922/gtm.312