It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore a negative emotional experience. Accordingly, pain is that experience we associate with actual or potential tissue damage. Biologists recognize that those stimuli which cause pain are liable to damage tissue.
Pain is always subjective in that each individual learns the application of the word through their own experiences. The International Association for the Study of Pain defines it as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” ( 1). This essay provides a framework for thinking about chronic pain and developing new treatment approaches. Developing new treatment strategies for patients with chronic pain is of utmost urgency. Unfortunately, treatments for chronic pain are woefully inadequate and often worsen clinical outcomes. We and others have shown a complex relationship between the physiologic stress response and chronic pain symptoms. One important contributor to chronic pain is perceived stress and stress response systems. Genetic, physiologic, and psychological factors associated with central pain amplification are beginning to be understood. Furthermore, patients with somatic symptom disorders may have alterations in their psychological or behavioral responses to pain that contribute significantly to the clinical presentation. In any individual, central pain amplification may complicate nociceptive or neuropathic pain. Central pain amplification is perceived pain that cannot be fully explained on the basis of somatic or neuropathic processes and is due to physiologic alterations in pain transmission or descending pain modulatory pathways.
Email for log-in credentials.Chronic musculoskeletal pain is one of the most intractable clinical problems faced by clinicians and can be devastating for patients. This is an app for faculty and residents at ACGME-approved thoracic surgery residency programs have access rights. * Read or watch the content directly from iPhone or iPad * Find the right article your way! Search by topic, course or textbook or visually browse connected topics. * See connections and surgical concepts come to life in a dynamic and interactive mind map
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