A systems model of chronic musculo-skeletal pain

A comprehensive systems model of chronic musculo-skeletal pain is presented. Physical and mechanical events may impinge directly upon the organism to produce pain. In addition life experience, as interpreted by each individual, may result in unpleasant affect which may lead through three psychosomatic pathways to musculo-skeletal pain. The suggested pathways are conversion, dysponesis and neurotransmitter disturbance. It is suggested that the construing of the self as being "ill", "an invalid" or a "pain person" is a crucial step in the development of the chronic pain syndrome and that therapies which fail to change this self-construct are unlikely to meet with long-term success.