Chronic secondary musculoskeletal pain associated with structural changes

Description

Chronic secondary musculoskeletal pain associated with structural changes is chronic pain of unknown mechanism(s) that is attributable to anatomical changes in joint(s), bone(s) or tendon(s). The structural change needs to be inferred from clinical examination and/or demonstrable on imaging. The pain may be spontaneous or movement-induced. It is characterised by clinical features such as swelling, allodynia or restricted movement. Diagnostic Criteria: Conditions A to D are fulfilled: A) Chronic pain (persistent or recurrent for longer than 3 months) in joint(s), bone(s), or tendon(s) is present. The pain may be spontaneous or movement induced. B) At least one of the following fulfilled: B1) Swelling is present. B2) Allodynia over the part is present. C) The structural change is inferred from clinical examination or imaging. D) The pain is not better accounted for by another diagnosis of chronic pain.

Coding note from above levels

If the pain is related to visceral lesions, it should be considered whether a diagnosis of chronic visceral pain is appropriate; if it is related to neuropathic mechanisms, it should be coded under chronic neuropathic pain; and if the pain mechanisms are non-specific, chronic musculoskeletal pain should be coded under chronic primary pain.

This code should be used if a pain condition persists or recurs for longer than 3 months.

Inclusions

• Chronic secondary musculoskeletal pain associated with osteoarthritis
• Chronic secondary musculoskeletal pain associated with spondylosis

Exclusions from above levels

• MG30.0 – Chronic primary pain
• MG30.4 – Chronic secondary visceral pain
• MG30.5 – Chronic neuropathic pain