direct growth and penetration by the tumour and/or metastases (70%)
treatment, such as surgery, radiotherapy or chemotherapy (20%)
associated factors (e.g. constipation, bed sores, muscular spasms, infections) or comorbidity not related to the malignancy (10%)
Pain as a consequence of tumour growth is mostly due to:
bone metastases (local bone destruction, fracture, extraossal infiltration of soft tissues, compression of spinal cord or nerve roots) (28%)
infiltration of soft tissues (26%)
infiltration of viscera (25%)
compression or infiltration of nerves or nerve plexus (18%)
An important cause of pain in patients with AIDS is neuropathy as a consequence of the disease and/or treatment with antiretroviral drugs. In addition to this, myalgias and pain as a consequence of infections at various locations also occur.
In the case of patients with life-threatening neurological conditions (e.g. ALS or MS) neuropathic pain occurs as a consequence of damage to the central or peripheral nervous system, often in combination with nociceptive pain, for example due to muscle cramps or bed sores.
In patients with heart failure, pain associated with the musculoskeletal system often occur.
In patients with COPD, chest pains often occur as a consequence of pneumonia with pleural sensitivity, pulmonary embolisms or rib fractures.