Chronic Pain
Section Author: David A. Williams (University of Michigan)
Description
Chronic pain affects between 10% -17% of the US population or roughly 70 million adults. There are many forms of chronic pain including Rheumatologic pain (such as arthritis), low back pain, cancer-related pain, headache, neurological pain, and musculoskeletal pain. While acute pain acts as a warning signal of actual or imminent damage to the body, chronic pain appears to have no inherent value for survival and is best thought of as a disorder. Interventions for acute pain often fail for chronic pain suggesting different underlying pathophysiologic mechanisms and the need for distinct approaches to treatment. Pain perception is an integration of nociception (neural sensory system), affect, and cognitive evaluation. Any aspect of this integrated experience can become aberrant and contribute to the maintenance and/or exacerbation of pain. Interventions for acute pain tend to target the nociceptive system; successful interventions for chronic pain tend to be those that address affective, cognitive, and behavioral factors as well. There are many forms of chronic pain and while some psychological interventions may be effectively applied to all, other psychological interventions may have greater utility if targeted towards specific disorders or specific aspects of those chronic pain conditions.