JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (28) Citing Articles via Google Scholar Google Scholar Articles by Siddall, P. J. Articles by Cousins, M. J. Search for Related Content PubMed PubMed Citation Articles by Siddall, P. J. Articles by Cousins, M. J. Related Collections Pain

---

PAIN MEDICINE

Persistent Pain as a Disease Entity: Implications for Clinical Management

Department of Anaesthesia & Pain Management and Pain Management Research Institute, University of Sydney, Royal North Shore Hospital, Sydney, NSW, Australia

Address for correspondence and reprint requests to Dr. Philip Siddall, Pain Management and Research Centre, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia. Address e-mail to phils{at}med.usyd.edu.au

Pain has often been regarded merely as a symptom that serves as a passive warning signal of an underlying disease process. Using this model, the goal of treatment has been to identify and address the pathology causing pain in the expectation that this would lead to its resolution. However, there is accumulating evidence to indicate that persistent pain cannot be regarded as a passive symptom. Continuing nociceptive inputs result in a multitude of consequences that impact on the individual, ranging from changes in receptor function to mood dysfunction, inappropriate cognitions, and social disruption. These changes that occur as a consequence of continuing nociceptive inputs argue for the consideration of persistent pain as a disease entity in its own right. As with any disease, the extent of these changes is largely determined by the internal and external environments in which they occur. Thus genetic, psychological and social factors may all contribute to the perception and expression of persistent pain. Optimal outcomes in the management of persistent pain may be achieved not simply by attempting to remove the cause of the pain, but by addressing both the consequences and contributors that together comprise the disease of persistent pain.

This article has been cited by other articles:

				J. P. Rathmell A 50-Year-Old Man With Chronic Low Back Pain JAMA, May 7, 2008; 299(17): 2066 - 2077. [Abstract] [Full Text] [PDF]

				J. Gardner-Nix, S. Backman, J. Barbati, and J. Grummitt Evaluating distance education of a mindfulness-based meditation programme for chronic pain management J Telemed Telecare, March 1, 2008; 14(2): 88 - 92. [Abstract] [Full Text] [PDF]

				F. Brennan, D. B. Carr, and M. Cousins The Role of Opioids in Pain Management Anesth. Analg., December 1, 2007; 105(6): 1865 - 1866. [Full Text] [PDF]

				F. Brennan, D. B. Carr, and M. Cousins Pain Management: A Fundamental Human Right Anesth. Analg., July 1, 2007; 105(1): 205 - 221. [Abstract] [Full Text] [PDF]

				P. J. Siddall, M. J. Cousins, A. Otte, T. Griesing, R. Chambers, and T. K. Murphy Pregabalin in central neuropathic pain associated with spinal cord injury: A placebo-controlled trial Neurology, November 28, 2006; 67(10): 1792 - 1800. [Abstract] [Full Text] [PDF]

				R. R. Edwards Individual differences in endogenous pain modulation as a risk factor for chronic pain Neurology, August 9, 2005; 65(3): 437 - 443. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999