Contemporary approaches to diagnostics and treatment of nociceptive primary musculoskeletal pain

Abstract

This article discusses contemporary approaches to multimodal, NSAID-sparing management of primary musculoskeletal pain. Despite the scientific advances, musculoskeletal pain remains extremely challenging to manage clinically. While the number of potential treatment targets has grown substantially and a strong case has been made for a mechanism-based and individualized approach to pain therapy, arguably clinicians are not much more advanced now in their capacity to either diagnose or effectively treat patients with musculoskeletal pain. The International Association for the Study of Pain (IASP) pain taxonomy includes pain mechanisms as one of the 3 dimensions that need to be considered when making a diagnostic classification for the concurrent use of separate therapeutic interventions with various mechanisms of action aimed at different pain mechanisms. Combination of shock-wave therapy with topical NSAID tenoxicam is more effective in primary musculoskeletal pain treatment.