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Is chronic pain a disease?

Milton Cohen¹, John Quintner, David Buchanan

¹Pain Medicine and Rheumatology, St Vincent's Campus, Sydney, New South Wales.

Pain Medicine (Malden, Mass.)

|January 9, 2013

Summary

Chronic pain is not a disease itself but a complex symptom. Current theories, including neuroplasticity, better explain pain than the disease model, which has conceptual flaws and may hinder progress.

Area of Science:

Neuroscience
Pain Medicine
Pathophysiology

Background:

Neuroplasticity and central sensitization challenge traditional pain theories.
The concept of chronic pain as a distinct disease, with proposed categories of "eudynia" and "maldynia," has gained traction.
This evolving understanding necessitates a re-evaluation of pain theory.

Purpose of the Study:

To critically examine the proposition that chronic pain is a disease.
To analyze the evolution of pain medicine theory in light of neuroplasticity.
To evaluate the conceptual underpinnings of the pain-as-a-disease model.

Main Methods:

A critical review of existing pain theories was performed.
The study framework involved the historical evolution of pain medicine.

Keywords:

Chronic Pain Disease Pain Theory

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Analysis focused on the logical consistency and empirical support for different pain models.

Main Results:

Three dominant theories identified: specificity, neuroplasticity, and pain-as-a-disease.
Neuroplasticity theory offers a more robust explanation for chronic pain phenomena than specificity theory.
The pain-as-a-disease model is flawed due to conflating symptoms, causes, and pathology, and misinterpreting concepts.

Conclusions:

The proposition of chronic pain as a disease lacks clinical and pathological support.
Classifying pain as "good" or "bad" may impede scientific advancement and treatment strategies.
A revised approach is needed to resolve theoretical impasses in pain science.