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What is chronic pain?
1Department of Neurological Surgery, University of Washington, School of Medicine, Seattle 98195.
Theoretical Medicine
|September 1, 1991
Summary
Chronic pain is a growing epidemic, often misunderstood by Western medicine. Rethinking pain conceptualization and focusing on behavioral outcomes is crucial for effective treatment and managing societal costs.
Area of Science:
- Medical Sociology
- Pain Management
- Public Health
Background:
- Chronic pain imposes significant individual suffering and escalating healthcare costs globally.
- The incidence of disabling chronic pain and associated healthcare utilization are rapidly increasing.
- Current Western medical approaches are often ineffective and may contribute to the chronic pain epidemic.
Purpose of the Study:
- To identify factors contributing to the confusion surrounding chronic pain of unknown etiology.
- To propose alternative conceptualizations of chronic pain, its behaviors, and social consequences.
Main Methods:
- Conceptual analysis of existing literature on chronic pain.
- Distinguishing between distinct elements: tissue damage, pain, suffering, pain behaviors, healthcare consumption, impairment, and disability.
- Examining the social and economic implications of chronic pain.
Main Results:
- Confusion in understanding chronic pain stems from conflating distinct but related concepts.
- A clear differentiation between tissue damage, pain perception, and disability is essential.
- Industrialized society's demands and coping failures contribute to disabling chronic pain.
Conclusions:
- Effective conceptualization requires discriminating between tissue damage, pain, suffering, pain behaviors, healthcare consumption, impairment, and disability.
- Successful treatment should be measured by behavioral restoration, such as resuming normal activities.
- Disabling chronic pain can be an indicator of overwhelming stress from societal pressures.