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Updated: May 24, 2025

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
Published on: April 14, 2016
A cumulative strain model for chronic pain and multimorbidity
Chris Hayes1, Laura Bruggink2, Hema Rajappa3
1FFPMANZCA, MMed, Specialist Pain Medicine Physician, Director, Hunter Integrated Pain Service, NSW.
Background:
Chronic pain often occurs amidst multimorbidity. The proposed cumulative strain model postulates diverse but interlinked biological mechanisms of strain playing a role in the causation of multiple chronic conditions, including chronic pain. Modulators of strain include mindbody, connection, activity, nutrition and biomedical aspects. These modulators can be targeted therapeutically to bring a shift towards wellness.
Objective:
The aim of this paper is to highlight common mechanisms underpinning chronic conditions and prompt consideration of how these mechanisms might be targeted therapeutically in primary care.
Discussion:
The recognition of common underlying mechanisms and treatments for chronic conditions, including chronic pain, opens the way for consideration of generic chronic condition programs in primary care, and hence a reduced requirement for condition-specific specialist referrals.
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