- Biologic: severity and extent of surgery, trauma[1] or disease condition (eg, poly-trauma, including burns), persistent cancer-related pain[2], genetic factors[3] including sickle cell disease[4], recurrent bouts of autoimmune inflammatory disease[5], metabolic disorders (eg diabetes), advanced age[6] and frailty.
|
- Psychological: pre-existing mental health issues[7] (eg, poorly controlled depression, anxiety, catastrophizing, PTSD.)
|
- Substance use or abuse (includes: tobacco, alcohol, sedatives, opioids[8])
|
- Social: disabled, disconnection[9], loneliness[9], unstable housing, poverty, low health literacy, poor access to medical and behavioral care
|
- Repeated surgeries[10] or ineffective procedures intended to relieve the same pain condition
|
- Unintended and/or prolonged exposure to opioid analgesics[11]
|
- Pre-existing wide-spread pain (eg, fibromyalgia[12])
|