Pain: Going upstream


Richmond Stace

Pain Physio Clinics LLP, UK

: Analg Resusc: Curr Res

Abstract


Traditionally the location of the pain was thought of as the seat of the problem and hence the target for treatment. Pain science has developed our thinking so that now we must consider pain as an emergent property of the whole person, involving many body systems–nervous, autonomic, endocrine and immune. The body systems do not work in isolation to each other, but rather, they function in an integrated manner, responding to actual and potential threats. In this talk, Richmond will explore the current understanding of pain and how it is embedded within the functioning of the body systems, the individual and their life. Illustrating this with clinical examples, Richmond will describe how the biology manifests in chronic pain states, including the influence of stress, cognition, the environment, beliefs, prior experience, attention and expectations.Despite the complexities of pain, Richmond will argue that patients need to understand their pain to form a foundation from where they can move forward. Both the biology of pain and the range of influences must be elucidated and then explained to the patient– these are the beginnings of the treatment programme. Examples of modern approaches will be given with rationale.The overall aim of the talk is to highlight what we know about pain and how we can use modern pain science to change the thinking on pain to start changing what is the largest global health burden.

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