Diagnosing and assessing pain in neurorehabilitation: from translational research to the clinical setting. Evidence and recommendations from the Italian Consensus conference on pain in neurorehabilitation

Pain is very common in neurorehabilitation, where it may be a target for treatment and have a negative effect on rehabilitation procedures and outcomes. Promising preliminary preclinical data support some therapeutic approaches to pain, but there is a strong need of adequate preclinical models, experimental settings, outcome measures, and biomarkers that could be more relevant for pain within the neurorehabilitation field. Data on diagnosis and assessment of nociceptive and neuropathic pain (NP) are very scanty in neurorehabilitation, but those from other contexts can be adapted and translated in this specific setting. The Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) searched and evaluated existing evidence on animal models for the treatment of pain, definition and diagnostic criteria for nociceptive and NP, screening tools and questionnaires, together with diagnostic clinical and instrumental techniques for separating nociceptive from NP and more in general for the assessment of pain in the field of neurorehabilitation. The present ICCPN recommendations give information on the relevance of current preclinical models, and may be helpful for ameliorating pain diagnosis and assessment, which are prerequisites for better application and tailoring of current pharmacological and non-pharmacological treatments for pain in neurorehabilitation. They may also be useful for future studies aimed to fill the knowledge gaps on these topics.