Understanding Chronic Pain

What is Chronic Pain?

[From Chapter 2 of Understanding Chronic Pain]

Pain is a universal human experience. We all know what it is like. Few of us, however, know enervating and debilitating chronic pain. What is it that distinguishes the disease chronic pain from the inevitable and sometimes incessant pain that we all endure? It is difficult to make a certain distinction. Unfortunately, there is as yet no adequate definition of the disease. The reasons for this are several, and they are worth exploring.

Chronic pain is a very protean illness. It has many faces. It may appear as fibromyalgia, back pain, tension headache, or any of the myriad other painful disorders. Thus, our attempt to define the illness is much like the proverbial blind men trying to describe the elephant. Each recognizes a part, none identify the whole. We can actually name the blind men. One is a rheumatologist who describes fibromyalgia. Another, an orthopedist, who describes a ruptured lumbar disc. A gynecologist describes chronic pelvic pain; a neurologist, tension headache; and a psychiatrist, depression. The list could be extended indefinitely. Every physician, specialist or generalist, encounters the syndrome of chronic pain. Each sees a piece of it. Few see the whole.

Let's compare chronic pain with cancer and infectious disease, for these, too, are very protean illnesses. There are many types of cancer, and they behave quite differently. There are many types of infectious disease. Some are caused by viruses, others by bacteria, and yet others by fungi. According to the type of organism, infections will show enormous variability in their clinical expressions. Nonetheless, we recognize that cancer and infection each represent a single core disease. We know this because we can see, under the microscope, the nature of the illness. We cannot, however, see the nature of painfulness under the microscope. There is not as yet, nor will there likely be in the foreseeable future, a diagnostic test for pain. Nonetheless, there are ample reasons to presume that a state of chronic pain represents, like cancer and infection, a single core illness.

You can read the rest in Dr. Cochran's book, Understanding Chronic Pain

Last Updated: Nov 19, 08:04 AM

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