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Imagine an orchestra in your brain. It plays all kinds of harmonious melodies, then pain comes along and the different sections of the orchestra are reduced to a few pain tunes. All pain is real. And for many people it is a debilitating part of everyday life. It is now known that understanding more about why things hurt can actually help people to overcome their pain. Recent advances in fields such as neurophysiology, brain imaging, immunology, psychology and cellular biology have provided an explanatory platform from which to explore pain. In everyday language accompanied by quirky illustrations, Explain Pain discusses how pain responses are produced by the brain: how responses to injury from the autonomic motor and immune systems in your body contribute to pain, and why pain can persist after tissues have had plenty of time to heal. Explain Pain aims to give clinicians and people in pain the power to challenge pain and to consider new models for viewing what happens during pain. Once they have learnt about the processes involved they can follow a scientific route to recovery. The Authors: Dr Lorimer Moseley is Professor of Clinical Neurosciences and the Inaugural Chair in Physiotherapy at the University of South Australia, Adelaide, where he leads research groups at Body in Mind as well as with Neuroscience Research Australia in Sydney. Dr David Butler is an international freelance educator, author and director of the Neuro Orthopaedic Institute, based in Adelaide, Australia. Both authors continue to publish and present widely.
An expert explores the biological and emotional nature of pain: why it hurts and why some pain is good and some pain is bad. If you touch something hot, it hurts. You snatch your hand away from the hot thing immediately. Obviously. But what is really happening, biologically—and emotionally? In Understanding Pain, Fernando Cervero explores the mechanisms and the meaning of pain. When you touch something hot, your brain triggers a reflex action that causes you to withdraw your hand, protecting you from injury. That kind of pain, Cervero explains, is actually good for us; it acts as an alarm that warns us of danger and keeps us away from harm. But, Cervero tells us, not all pain is good for you. There is another kind of pain that is more like a curse: chronic pain that is not related to injury. This is the kind of pain that fills pain clinics and makes life miserable. Cervero describes current research into the mysteries of chronic pain and efforts to develop more effective treatments. Cervero reminds us that pain is the most common reason for people to seek medical attention, but that it remains a biological enigma. It is protective, but not always. Its effects are not only sensory but also emotional. There is no way to measure it objectively, no test that comes back positive for pain; the only way a medical professional can gauge pain is by listening to the patient's description of it. The idea of pain as a test of character or a punishment to be borne is changing; prevention and treatment of pain are increasingly important to researchers, clinicians, and patients. Cervero's account brings us closer to understanding the meaning of pain.
Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.
People who suffer from chronic pain are typically found to be more anxious and fearful of pain than those who do not. Recent evidence has shown that the fear itself serves as a mechanism through which chronic pain is maintained over time. Even once the muscle or tissue damage is healed, a fearof further pain can lead to avoidance behaviour, which over time, leads to deconditioning (e.g. decreased mobility, weight gain). This in turn leads to further pain experiences, negative expectancies, and strengthened avoidance. It is the reciprocal relationship between fear and avoidance that isthought to be responsible for maintaining pain behaviour and disability. With fear of pain known to cause significant suffering and functional disability, there is a need for a greater understanding of this condition. This is the first book to explore this topic. It starts by introducing the current theoretical positions regarding pain-related fear and anxiety alongwith relevant empirical findings. It then provides comprehensive coverage of assessment issues and treatment strategies. Finally, the book suggests further areas for investigation. Pain-related fear and anxiety are now receiving considerable attention, and efficient and effective treatments are fast becoming available. This book will help guide and extend our understanding of a condition that has been shown to be associated with substantial suffering and disability.
Richeimer's compassionate and holistic approach can help soften the harsh edges of pain and provide hope for the future.
Painâ€"it is the most common complaint presented to physicians. Yet pain is subjectiveâ€"it cannot be measured directly and is difficult to validate. Evaluating claims based on pain poses major problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and dysfunction; clinical aspects of prevention, diagnosis, treatment, and rehabilitation; and how the SSA's benefit structure and administrative procedures may affect pain complaints.
A comprehensive review of the current state of thinking and research in relation to the management of the psychological aspects of pain. Written in a style and at a level which is relevant and accessible to the practising clinician and also to students. Addresses the common clinical problems relating to the psychological aspects of pain management and gives practical guidance based on the latest research as to how those problems should be dealt with. Includes an appendix which may be used as a session manual by therapists using cognitive-behavioural therapy with groups for early intervention in pain management. May be used as a textbook as well as a clinical reference. Volume 16 in an established series conceived and commissioned by Sir Patrick Wall Written by probably the best known figure in the field of the psychological management of pain Clinically relevant and research based Written by a leading researcher who is also a practitioner and understands the problems and concerns of clinicians Fully up to the minute - based on the very latest research
The relationship between chronic pain and addiction Patients with chronic pain understandably seek relief from their distress and discomfort, but many medications that alleviate pain are potentially addictive, and most chronic pain conditions only have a temporary response to opiate analgesic drugs. This volume reviews the fundamental topics that underlie the complex relationships of this controversial domain. The authors review behavioral models and practical methods for understanding and treating chronic pain and addiction including methods to formulate patients with complex comorbidity and screen patients with chronic pain for addictive liability. Finally, the authors describe the current findings from clinical and basic science that illuminate the role of opiates, cannabinoids and ketamine in the treatment of chronic pain. Up to date and comprehensive, this book is relevant to all professionals engaged in the care of patients with chronic pain or addiction and all others interested in these contemporary issues, particularly non-clinicians seeking clarity in the controversy over the best approach to patients with chronic pain.
In August, 1985, the 2nd International Conference on Illness Behaviour was held in Toronto, Ontario, Canada. The first International Conference took place one year previous in Adelaide, South Australia, Australia. This book is based on the proceedings of the second conference. The purpose behind this conference was to facilitate the development of a single integrated model to account for illness experience and presentation. A major focus of the conference was to outline methodological issues related to current behaviour research. A multidiscipl~nary approach was emphasized because of the bias that collaborative efforts are likely to be the most successful in achieving greater understanding of illness behaviour. Significant advances in our knowledge are occurring in all areas of the biological and social sciences, albeit more slowly in the latter areas. Marked specialization in each of these areas has lead to greater difficulty in integrating new knowledge with that of other areas and the development of a meaningful cohesive model to which all can relate. Thus there is a major need for forums such as that provided by this conference.