U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Pain, Intractable

MedGen UID:
14574
•Concept ID:
C0030200
•
Sign or Symptom
Synonyms: Intractable Pain; Intractable Pains; Pain, Refractory; Pains, Intractable; Pains, Refractory; Refractory Pain; Refractory Pains

Definition

Persistent pain that is refractory to some or all forms of treatment. [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPain, Intractable

Professional guidelines

PubMed

Current Understanding of Phantom Pain and its Treatment.
Culp CJ, Abdi S
Pain Physician 2022 Oct;25(7):E941-E957. PMID: 36288580
Progress in the treatment of diabetic peripheral neuropathy.
Yang K, Wang Y, Li YW, Chen YG, Xing N, Lin HB, Zhou P, Yu XP
Biomed Pharmacother 2022 Apr;148:112717. Epub 2022 Feb 19 doi: 10.1016/j.biopha.2022.112717. PMID: 35193039
Scheuermann's Kyphosis: Diagnosis, Management, and Selecting Fusion Levels.
Sardar ZM, Ames RJ, Lenke L
J Am Acad Orthop Surg 2019 May 15;27(10):e462-e472. doi: 10.5435/JAAOS-D-17-00748. PMID: 30407981

Recent clinical studies

Etiology

Medullary sponge kidney.
Gambaro G, Danza FM, Fabris A
Curr Opin Nephrol Hypertens 2013 Jul;22(4):421-6. doi: 10.1097/MNH.0b013e3283622b86. PMID: 23680648
Treatment of cancer pain.
Portenoy RK
Lancet 2011 Jun 25;377(9784):2236-47. doi: 10.1016/S0140-6736(11)60236-5. PMID: 21704873
Oral mucositis.
Raber-Durlacher JE, Elad S, Barasch A
Oral Oncol 2010 Jun;46(6):452-6. Epub 2010 Apr 18 doi: 10.1016/j.oraloncology.2010.03.012. PMID: 20403721
Coccygeal retroversion.
Dennell LV, Nathan S
Spine (Phila Pa 1976) 2004 Jun 15;29(12):E256-7. doi: 10.1097/01.brs.0000127194.97062.17. PMID: 15187650
Challenging or difficult headache patients.
Landy SH
Prim Care 2004 Jun;31(2):429-40, viii. doi: 10.1016/j.pop.2004.02.013. PMID: 15172517

Diagnosis

Only in Silence.
Eison D
Hastings Cent Rep 2018 May;48(3):3-4. doi: 10.1002/hast.845. PMID: 29806890
Intractable pain.
Viswanathan A, Burchiel KJ
Neurosurg Focus 2013 Sep;35(3):Introduction. doi: 10.3171/2013.7.FOCUS13277. PMID: 23991823
Medullary sponge kidney.
Gambaro G, Danza FM, Fabris A
Curr Opin Nephrol Hypertens 2013 Jul;22(4):421-6. doi: 10.1097/MNH.0b013e3283622b86. PMID: 23680648
Treatment of cancer pain.
Portenoy RK
Lancet 2011 Jun 25;377(9784):2236-47. doi: 10.1016/S0140-6736(11)60236-5. PMID: 21704873
Central post-stroke pain: clinical characteristics, pathophysiology, and management.
Klit H, Finnerup NB, Jensen TS
Lancet Neurol 2009 Sep;8(9):857-68. doi: 10.1016/S1474-4422(09)70176-0. PMID: 19679277

Therapy

Defining refractory rheumatoid arthritis.
Buch MH
Ann Rheum Dis 2018 Jul;77(7):966-969. Epub 2018 Mar 27 doi: 10.1136/annrheumdis-2017-212862. PMID: 29588276
The coronary sinus reducer: clinical evidence and technical aspects.
Giannini F, Aurelio A, Jabbour RJ, Ferri L, Colombo A, Latib A
Expert Rev Cardiovasc Ther 2017 Jan;15(1):47-58. doi: 10.1080/14779072.2017.1270755. PMID: 27935738
Are cannabinoids effective for treatment of pain in patients with active cancer?
Lobos Urbina D, Peña Durán J
Medwave 2016 Sep 14;16 Suppl 3:e6539. doi: 10.5867/medwave.2016.6539. PMID: 27635982
Central neuromodulation for refractory pain.
Moore NZ, Lempka SF, Machado A
Neurosurg Clin N Am 2014 Jan;25(1):77-83. Epub 2013 Oct 10 doi: 10.1016/j.nec.2013.08.011. PMID: 24262901Free PMC Article
Cancer pain.
Bruera E, Kim HN
JAMA 2003 Nov 12;290(18):2476-9. doi: 10.1001/jama.290.18.2476. PMID: 14612485

Prognosis

Defining refractory rheumatoid arthritis.
Buch MH
Ann Rheum Dis 2018 Jul;77(7):966-969. Epub 2018 Mar 27 doi: 10.1136/annrheumdis-2017-212862. PMID: 29588276
Medullary sponge kidney.
Gambaro G, Danza FM, Fabris A
Curr Opin Nephrol Hypertens 2013 Jul;22(4):421-6. doi: 10.1097/MNH.0b013e3283622b86. PMID: 23680648
Treatment of cancer pain.
Portenoy RK
Lancet 2011 Jun 25;377(9784):2236-47. doi: 10.1016/S0140-6736(11)60236-5. PMID: 21704873
Auriculotherapy stimulation for neuro-rehabilitation.
Oleson T
NeuroRehabilitation 2002;17(1):49-62. PMID: 12016347
Pathophysiology of joint pain.
Perrot S, Guilbaud G
Rev Rhum Engl Ed 1996 Jul-Sep;63(7-8):485-92. PMID: 8896062

Clinical prediction guides

New insights into perineural invasion of pancreatic cancer: More than pain.
Liang D, Shi S, Xu J, Zhang B, Qin Y, Ji S, Xu W, Liu J, Liu L, Liu C, Long J, Ni Q, Yu X
Biochim Biophys Acta 2016 Apr;1865(2):111-22. Epub 2016 Jan 12 doi: 10.1016/j.bbcan.2016.01.002. PMID: 26794395
Refractory migraine and chronic migraine: pathophysiological mechanisms.
Goadsby PJ, Hargreaves R
Headache 2008 Oct;48(9):1399-405. doi: 10.1111/j.1526-4610.2008.01274.x. PMID: 19006557
Implantable intrathecal pumps for chronic pain: highlights and updates.
Knight KH, Brand FM, Mchaourab AS, Veneziano G
Croat Med J 2007 Feb;48(1):22-34. PMID: 17309136Free PMC Article
Intrathecal ziconotide for refractory pain.
Doggrell SA
Expert Opin Investig Drugs 2004 Jul;13(7):875-7. doi: 10.1517/13543784.13.7.875. PMID: 15212625
CT-guided percutaneous selective cordotomy.
Kanpolat Y, Akyar S, Cağlar S, Unlü A, Bilgiç S
Acta Neurochir (Wien) 1993;123(1-2):92-6. doi: 10.1007/BF01476292. PMID: 8213285

Recent systematic reviews

Treatment with bone-seeking radionuclides for painful bone metastases in patients with lung cancer: a systematic review.
Zacho HD, Karthigaseu NN, Fonager RF, Petersen LJ
BMJ Support Palliat Care 2017 Sep;7(3):230-237. Epub 2016 Jan 27 doi: 10.1136/bmjspcare-2015-000957. PMID: 26817791
African Americans' Perceptions of Pain and Pain Management: A Systematic Review.
Booker SQ
J Transcult Nurs 2016 Jan;27(1):73-80. Epub 2014 May 19 doi: 10.1177/1043659614526250. PMID: 24841472
WITHDRAWN: Radiotherapy for the palliation of painful bone metastases.
McQuay HJ, Collins SL, Carroll D, Moore RA, Derry S
Cochrane Database Syst Rev 2013 Nov 22;2013(11):CD001793. doi: 10.1002/14651858.CD001793.pub2. PMID: 24271498Free PMC Article
WITHDRAWN: Comparative efficacy of epidural, subarachnoid, and intracerebroventricular opioids in patients with pain due to cancer.
Ballantyne JC, Carwood C, Gupta A, Bennett MI, Simpson KH, Dhandapani K, Lynch L, Baranidharan G
Cochrane Database Syst Rev 2013 Oct 25;2013(10):CD005178. doi: 10.1002/14651858.CD005178.pub2. PMID: 24163272Free PMC Article
Common biological pathways underlying the psychoneurological symptom cluster in cancer patients.
Kim HJ, Barsevick AM, Fang CY, Miaskowski C
Cancer Nurs 2012 Nov-Dec;35(6):E1-E20. doi: 10.1097/NCC.0b013e318233a811. PMID: 22228391

Supplemental Content

Table of contents

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Related information

    • MeSH
      Related Medical Subject Headings
    • PMC Articles
      Related information in PubMed Central Links
    • PubMed
      Related literature resources in PubMed

    Recent activity

    Clear Turn Off Turn On

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...