What is chronic pain?
It was Rene Descarte who proposed the theory of pain that has persisted for nearly 400 years. Descarte thought that there were specific pain receptors and nerve fibres that projected pain impulses to the spinal cord and on to a specific pain centre in the brain. This implicated that the experience of pain was physical in nature and equated to peripheral tissue injury. Even today many healthcare professionals still view pain according to this biomedical model, that pain reflects tissue damage, and overlook psychological contributors to pain such as past experience, fears or anxiety.
The purpose of this series of articles is to briefly explore what pain is, the types of pain we experience such as nociception and peripheral neurogenic pain, to clarify chronic pain (pain that persists) and to discuss chronic pain in terms of a threat specific neuromatrix approach.
Pain
The International Association for the Study of Pain defines pain as… “an unpleasant sensory and emotional experience associated with actual or potential damage”. The term “chronic” describes the duration of pain and does not give any insight into the pain mechanism. Lorimar Moseley suggests that pain is part of a multi system output that motivates and assists the individual to get out of a situation that the brain perceives to be threatening (ref. Explain Pain lecture). As we will explore through this article, the key terms in this statement are “multi system output” and “what the brain perceives to be threatening” (this is particularly pertinent for persistent pain).
More to follow…