Skip to main content
SpringerLink
Log in

Pain and Complex Adaptive System Theory

  • Chapter
  • First Online:
Handbook of Systems and Complexity in Health

Abstract

Chronic pain is an expensive and growing problem within industrialised countries [1–4]. The ever-expanding volume of research in this area ranges across physiological and bio-psychosocial models and runs parallel to changes in social attitudes and beliefs towards health [5]. In a bio-psychosocial model, pain is conceptualised as a perception based on the interaction between physiology (specific pain receptors) and emotional, motivational and cognitive modifying factors [6]. There is an apparent reluctance of many medical professionals to abandon this body/mind dualism so the search for a cause and cure continues, as does the confusion and frustration of people seeking help for chronic pain. Chronic pain research is often unidisciplinary, lacking the interdisciplinary focus to generate integrated theory and interventions. To describe pain research, Sullivan and Lewin use the analogy of a group of people in a dark room who describe an elephant based on what they can touch [7]; many disciplines touch a piece of the elephant that is called pain, but most cannot tell whether they have the trunk or the tail.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Notes

  1. 1.

    “Focusing on the inadequacy of models to reflect or ­predict the infinite subtlety of human behaviour, and the false promises of the Evidence-Based Medicine movement, Willis encourages us to have faith in our own intuitions as doctors, teachers, managers, or in whatever roles we play in relating to other human beings”. Review by Douglas Jeffries, GP, on the Amazon.UK website (http://www.amazon.co.uk/exec/obidos/ASIN/1857754042/qid=1093000452/sr=1-6/ref=sr_1_8_6/026-6750948-5058031).

  2. 2.

    Centre for Complexity Research—http://www.liv.ac.uk/ccr/, The Complexity Society—http://www.complexity-society.com/, Plexus Institute—http://www.plexusinstitute.org/services/Fractal_Networks.cfm, Complexity in Primary Care—http://www.complexityprimarycare.org, and Health Complexity Group—http://www.healthcomplexity.net.

References

  1. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84(1):95–103.

    Article  PubMed  CAS  Google Scholar 

  2. Thomsen AB, et al. Economic evaluation of multidisciplinary pain management in chronic pain patients. a qualitative systematic review. J Pain Symptom Manage. 2001;22(2):688–98.

    Article  PubMed  CAS  Google Scholar 

  3. Waddell G. Low back pain: a twentieth century health care enigma. Spine. 1996;21(24):2820–5.

    Article  PubMed  CAS  Google Scholar 

  4. Loeser JD. Economic implications of pain management. Acta Anaesthesiol Scand. 1999;43(9):957–9.

    Article  PubMed  CAS  Google Scholar 

  5. Rey R. The history of pain. London: Harvard University Press; 1993.

    Google Scholar 

  6. Melzack R, Taenzer P. Concepts of pain perception and therapy. Geriatrics. 1977;32(11):44–8.

    PubMed  CAS  Google Scholar 

  7. Sullivan S, Lewin ME. The economics and ethics of long-term care and disability. AEI studies. 467. Washington, DC: American Enterprise Institute for Public Policy Research; 1988. p. xii, 145.

    Google Scholar 

  8. Fillingham D. Open space. Take five. Health Serv J. 2002;112(5791):27.

    PubMed  Google Scholar 

  9. Dershin H. Nonlinear systems theory in medical care management. Physician Exec. 1999;25(3):8–13.

    PubMed  CAS  Google Scholar 

  10. Griffiths F, Byrne D. General practice and the new science emerging from the theories of ‘chaos’ and complexity. Br J Gen Pract. 1998;48(435):1697–9.

    PubMed  CAS  Google Scholar 

  11. Kernick D. The demise of linearity in managing health services: a call for post normal health care. J Health Serv Res Policy. 2002;7(2):121–4.

    Article  PubMed  Google Scholar 

  12. Sweeney K, Griffiths F. Complexity and healthcare: an introduction. Oxon: Radcliffe; 2002.

    Google Scholar 

  13. Dent EB. Complexity science: a Worldview shift. Emergence. 1999;1(4):5–19.

    Article  Google Scholar 

  14. Miller WL, et al. Understanding change in primary care practice using complexity theory. J Fam Pract. 1998;46(5):369–76.

    PubMed  CAS  Google Scholar 

  15. Plsek P. Complexity and the adoption of innovation in health care. In: Accelerating quality improvement in health care. Washington, DC; 2003.

    Google Scholar 

  16. Zimmerman B. Complexity science: a route through hard times and uncertainty. Health Forum J. 1999;42(2):42–6, 69.

    Google Scholar 

  17. Chapman RC, Nakamura Y. Consciousness, complexity, and causality: concerns and conundrums. Pain Forum. 1999;8(3):136–8.

    Article  Google Scholar 

  18. Plsek PE, Greenhalgh T. Complexity science: the challenge of complexity in health care. BMJ. 2001;323(7313):625–8.

    Article  PubMed  CAS  Google Scholar 

  19. Cilliers P. Complexity and postmodernism. London: Routledge; 1998.

    Google Scholar 

  20. Zimmerman B, Lindberg C, Plsek P. Edgeware: insights from complexity science for health care leaders. Irving, TX: VHS; 2001.

    Google Scholar 

  21. Godlee F, Smith J, Marcovitch H. Wakefield’s article linking MMR vaccine and autism was fraudulent. BMJ. 2011;342:c7452.

    Article  PubMed  Google Scholar 

  22. Wikipedia. Andrew Wakefield. 2001. http://en.wikipedia.org/wiki/Andrew_Wakefield#Epidemics_and_effects. Cited 16 Apr 2011.

  23. Stacey RD. Complexity and creativity in organizations. 2nd ed. London: Pitman; 1996.

    Google Scholar 

  24. Sardar Z, Abrams I. Introducing chaos. Cambridge: Icon; 1999.

    Google Scholar 

  25. Holland JH. Emergence: from chaos to order. Oxford: Oxford University Press; 1998.

    Google Scholar 

  26. Gleick J. Chaos. London: Vintage; 1998.

    Google Scholar 

  27. Wilson T, Holt T, Greenhalgh T. Complexity science: complexity and clinical care. BMJ. 2001; 323(7314): 685–8.

    Article  PubMed  CAS  Google Scholar 

  28. Burns JP. Complexity science and leadership in healthcare. J Nurs Adm. 2001;31(10):474–82.

    Article  PubMed  CAS  Google Scholar 

  29. Gillett G. Clinical medicine and the quest for certainty. Soc Sci Med. 2004;58(4):727–38.

    Article  PubMed  Google Scholar 

  30. Martin B. Dissent and heresy in medicine: models, methods, and strategies. Soc Sci Med. 2004; 58(4): 713–25.

    Article  PubMed  Google Scholar 

  31. Frost DP. Medicine, postmodernism, and the end of certainty. Complex systems result in a new kind of fundamental uncertainty. BMJ. 1997;314(7086): 1045.

    Article  PubMed  CAS  Google Scholar 

  32. Mays N, Pope C. Qualitative research in health care. Assessing quality in qualitative research. BMJ. 2000; 320(7226):50–2.

    Article  PubMed  CAS  Google Scholar 

  33. Tickle-Degnen L, Bedell G. Heterarchy and hierarchy: a critical appraisal of the “levels of evidence” as a tool for clinical decision making. Am J Occup Ther. 2003;57(2):234–7.

    Article  PubMed  Google Scholar 

  34. Freeman AC, Sweeney K. Why general practitioners do not implement evidence: qualitative study. BMJ. 2001;323(7321):1100–2.

    Article  PubMed  CAS  Google Scholar 

  35. Medical Research Council. A framework for development and evaluation of RCTs for complex interventions to improve health. London: Medical Research Council; 2000. p. 1–18.

    Google Scholar 

  36. Fraser SW, Greenhalgh T. Coping with complexity: educating for capability. BMJ. 2001;323(7316):799–803.

    Article  PubMed  CAS  Google Scholar 

  37. Plsek PE, Wilson T. Complexity, leadership, and ­management in healthcare organisations. BMJ. 2001; 323(7315):746–9.

    Article  PubMed  CAS  Google Scholar 

  38. WHO. Innovative care for chronic conditions: building blocks for action. Geneva: World Health Organisation; 2002.

    Google Scholar 

  39. Wordsworth W. The table turned. In: Matthew Arnold, editor. The poems of Wordsworth. London: MacMillan; 1947.

    Google Scholar 

  40. Griffiths F. Conclusions. In: Sweeney K, Griffiths F, editors. Complexity and healthcare: an introduction. Oxon: Radcliffe; 2002. p. 167–76.

    Google Scholar 

  41. Roberts G, et al. Describing chronic pain: towards bilingual practice. Int J Nurs Stud. 2003;40(8): 889–902.

    Article  PubMed  Google Scholar 

  42. Carter B. Chronic pain in childhood and the medical encounter: professional ventriloquism and hidden voices. Qual Health Res. 2002;12(1):28–41.

    PubMed  Google Scholar 

  43. Hafner C. The information we give may be detrimental. In: Gifford L, editor. Topical issues in pain. Falmouth: CNS; 2002. p. 101–18.

    Google Scholar 

  44. Kurtz C, Snowden D. The new dynamics of strategy: sense-making in a complex and complicated world. IBM Syst J. 2003;42(3):462–83.

    Article  Google Scholar 

  45. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38–48.

    Article  PubMed  CAS  Google Scholar 

  46. Dijkstra A, et al. Readiness to adopt the self-management approach to cope with chronic pain in fibromyalgic patients. Pain. 2001;90(1–2):37–45.

    Article  PubMed  CAS  Google Scholar 

  47. Lindbladh E, Lyttkens CH. Habit versus choice: the process of decision-making in health-related behaviour. Soc Sci Med. 2002;55(3):451–65.

    Article  PubMed  Google Scholar 

  48. Stevenson FA, et al. GPs’ recognition of, and response to, influences on patients’ medicine taking: the implications for communication. Fam Pract. 2000;17(2):119–23.

    Article  PubMed  CAS  Google Scholar 

  49. Salmon P, Peters S, Stanley I. Patients’ perceptions of medical explanations for somatisation disorders: qualitative analysis. BMJ. 1999;318(7180):372–6.

    Article  PubMed  CAS  Google Scholar 

  50. Ong LM, et al. Doctor-patient communication: a review of the literature. Soc Sci Med. 1995;40(7):903–18.

    Article  PubMed  CAS  Google Scholar 

  51. Hilbert R. The acultural dimensions of chronic pain: flawed reality construction and the problem of meaning. Soc Probl. 1984;31(4):365–78.

    Article  Google Scholar 

  52. Johansson EE, et al. The meanings of pain: an exploration of women’s descriptions of symptoms. Soc Sci Med. 1999;48(12):1791–802.

    Article  PubMed  CAS  Google Scholar 

  53. Kleinman A, Kleinman J. Suffering and its professional transformation: toward an ethnography of interpersonal experience. Cult Med Psychiatry. 1991;15(3):275–301.

    Article  PubMed  CAS  Google Scholar 

  54. Morris D. Sociocultural and religious meanings of pain. In: Gatchel RJ, Turk DC, editors. Psychosocial factors in pain: critical perspectives. New York: Guilford; 1999. p. 118–31.

    Google Scholar 

  55. Schussler G. Coping strategies and individual meanings of illness. Soc Sci Med. 1992;34(4):427–32.

    Article  PubMed  CAS  Google Scholar 

  56. Clinical Standards Advisory Group. A summary of the CSAG report on services for NHS patients with acute and chronic pain. CSAG Support Team, Unit of Health-Care Epidemiology, Institute of Health Sciences, 2000.

    Google Scholar 

  57. Caldron J, Beltran R. Pitfalls in health communication: healthcare policy, institution, structure and process. MedGenMed. 2004;6(1):9.

    Google Scholar 

  58. Society P. Pain management services: good practice. The Royal Collage of Anaesthetists and The Pain Society (British Chapter of ISASP): London; 2003.

    Google Scholar 

  59. IASP. Desirable characteristics of multidisciplinary pain centers. Seattle: International Association for the Study of Pain; 1990.

    Google Scholar 

  60. Bellon JA, Fernandez-Asensio ME. Emotional profile of physicians who interview frequent attenders. Patient Educ Couns. 2002;48(1):33–41.

    Article  PubMed  Google Scholar 

  61. Zinn WM. Doctors have feelings too. JAMA. 1988;259(22):3296–8.

    Article  PubMed  CAS  Google Scholar 

  62. Dempsey OP, Bekker HL. ‘Heads you win, tails I lose’: a critical incident study of GPs’ decisions about emergency admission referrals. Fam Pract. 2002;19(6):611–6.

    Article  PubMed  Google Scholar 

  63. Dubouloz C, et al. Occupational therapists’ perception of evidence-based practice. Can J Occup Ther. 1999;65:136–43.

    Google Scholar 

  64. Pollock A. Barriers to achieving evidence-based stroke rehabilitation. Clin Rehabil. 2000;14:611–7.

    Article  PubMed  CAS  Google Scholar 

  65. Gervais I, et al. Attempting to use a Cochrane Review: experience of three occupational therapists. Am J Occup Ther. 2002;56(1):110–3.

    Article  PubMed  Google Scholar 

  66. Belanger A. There are ‘continuing education alternatives’ to ‘alternative continuing education’ in physiotherapy. Physiother Can. 1997;49:249–52.

    Google Scholar 

  67. Funk SG, et al. Administrators’ views on barriers to research utilization. Appl Nurs Res. 1995;8(1):44–9.

    Article  PubMed  CAS  Google Scholar 

  68. Adler HM. The sociophysiology of caring in the doctor-patient relationship. J Gen Intern Med. 2002;17(11):874–81.

    Article  PubMed  Google Scholar 

  69. Novack DH, Epstein RM, Paulsen RH. Toward creating physician-healers: fostering medical students’ self-awareness, personal growth, and well-being. Acad Med. 1999;74(5):516–20.

    Article  PubMed  CAS  Google Scholar 

  70. Freemantle N. Are decisions taken by health care professionals rational? A non systematic review of experimantal and quasi experimental literature. Health Policy. 1996;38:71–81.

    Article  PubMed  CAS  Google Scholar 

  71. Fernandez E, Turk DC. The scope and significance of anger in the experience of chronic pain. Pain. 1995;61(2):165–75.

    Article  PubMed  CAS  Google Scholar 

  72. Sanders SH. Integrating practice guidelines for chronic pain: from the Tower of Babel to the Rosetta Stone [e-journal] 2000;10(6). http://www.ampainsoc.org/pub/bulletin/nov00/clin1/htm. Cited 21 Nov 2002.

  73. Peirce JC. The paradox of physicians and administrators in health care organizations. Health Care Manage Rev. 2000;25(1):7–28.

    Article  PubMed  CAS  Google Scholar 

  74. Jensen MP, Karoly P. Pain-specific beliefs, perceived symptom severity, and adjustment to chronic pain. Clin J Pain. 1992;8(2):123–30.

    Article  PubMed  CAS  Google Scholar 

  75. Dick BD, Rashiq S. Disruption of attention and working memory traces in individuals with chronic pain. Anesth Analg. 2007;104(5):1223–9. Tables of contents.

    Article  PubMed  Google Scholar 

  76. Flor H, Fydrich T, Turk DC. Efficacy of multidisciplinary pain treatment centers: a meta-analytic review. Pain. 1992;49(2):221–30.

    Article  PubMed  CAS  Google Scholar 

  77. Freeman M, Miller C, Ross N. The impact of individual philosophies of teamwork on multi-­professional practice and the implications for education. J Interprof Care. 2000;14(3):237–47.

    Article  Google Scholar 

  78. Main CJ, Richards HL, Fortune DG. Why put new wine in old bottles: the need for a biopsychosocial approach to the assessment, treatment, and understanding of unexplained and explained symptoms in medicine. J Psychosom Res. 2000;48(6):511–4.

    Article  PubMed  CAS  Google Scholar 

  79. Burton C. Introduction to complexity. In: Sweeney K, Griffiths F, editors. Complexity and healthcare: an introduction. Oxon: Radcliffe; 2002. p. 1–18.

    Google Scholar 

  80. Halliday S. Death and miasma in Victorian London: an obstinate belief. BMJ. 2001;323(7327):1469–71.

    Article  PubMed  CAS  Google Scholar 

  81. Pain Society. Desirable criteria for pain management programmes. London: Pain Society, The British & Irish Chapter of the International Association for the Study of Pain; 1997.

    Google Scholar 

  82. Dr Foster and the Pain Society. Adult chronic pain management services in the UK. London: Dr Foster; 2003.

    Google Scholar 

  83. Health and Welfare Canada. Chronic pain programs: report of the Subcommittee on Institutional Program Guidelines. Ottawa: Health and Welfare Canada; 1990.

    Google Scholar 

  84. Pain Society. Recommendations for nursing practice in pain management. London: The Pain Society; 2002.

    Google Scholar 

  85. Flower J, Guillaume P. Surfing the edge of chaos. Health Forum J. 2002;March:17–20.

    Google Scholar 

  86. Zimmerman B, Dooley K. Mergers versus emergers: structural change in health care systems. Emergence. 2001;3(4):65–82.

    Article  Google Scholar 

  87. Petros P. Non-linearity in clinical practice. J Eval Clin Pract. 2003;9(2):171–8.

    Article  PubMed  Google Scholar 

  88. Gardner JR, Sandhu G. The stigma and enigma of chronic non-malignant back pain (CNMBP) treated with long-term opioids (LTO). Contemp Nurse. 1997;6(2):61–6.

    Article  PubMed  CAS  Google Scholar 

  89. Haythornthwaite JA, et al. Factors associated with willingness to try different pain treatments for pain after a spinal cord injury. Clin J Pain. 2003;19(1):31–8.

    Article  PubMed  Google Scholar 

  90. Barnard S, Wiles R. Evidence-based physiotherapy: physiotherapists attitudes and experiences in the Wessex area. Physiotherapy. 2001;87(3):115–24.

    Article  Google Scholar 

  91. Upton DJ. How can we achieve evidence-based practice if we have a theory-practice gap in nursing today? J Adv Nurs. 1999;29(3):549–55.

    Article  PubMed  CAS  Google Scholar 

  92. Ernst E. Homeopathic prophylaxis of headaches and migraine? A systematic review. J Pain Symptom Manage. 1999;18(5):353–7.

    Article  PubMed  CAS  Google Scholar 

  93. Ezzo J, et al. Is acupuncture effective for the treatment of chronic pain? A systematic review. Pain. 2000;86(3):217–25.

    Article  PubMed  CAS  Google Scholar 

  94. McQuay HJ, et al. Systematic review of outpatient services for chronic pain control. Health Technol Assess. 1997;1(6):1–135.

    Google Scholar 

  95. van Tulder M, Koes B. Low back pain and sciatica: chronic. Clin Evid. 2002;7:1032–48.

    PubMed  Google Scholar 

  96. Redfern S, Christian S. Achieving change in health care practice. J Eval Clin Pract. 2003;9(2):225–38.

    Article  PubMed  Google Scholar 

  97. Kauffman S. Escaping the Red Queen effect. McKinsey Q. 1995;1:118–29.

    Google Scholar 

  98. Karjalainen KA, et al. Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. Cochrane Database Syst Rev. 2010;(3):CD002194.

    Google Scholar 

  99. Uhlig T, Finset A, Kvien TK. Effectiveness and cost-effectiveness of comprehensive rehabilitation programs. Curr Opin Rheumatol. 2003;15(2):134–40.

    Article  PubMed  Google Scholar 

  100. Thunberg KA, Hallberg LR. The need for organizational development in pain clinics: a case study. Disabil Rehabil. 2002;24(14):755–62.

    Article  PubMed  CAS  Google Scholar 

  101. Crossley M. Resistance to health promotion: a preliminary comparative investigation of British and Australian students. Health Educ. 2002;102(6):289–99.

    Article  Google Scholar 

  102. Bruehl S, Chung OY, Burns JW. Differential effects of expressive anger regulation on chronic pain intensity in CRPS and non-CRPS limb pain patients. Pain. 2003;104(3):647–54.

    Article  PubMed  Google Scholar 

  103. Green CR, et al. The unequal burden of pain: confronting racial and ethnic disparities in pain. Pain Med. 2003;4(3):277–94.

    Article  PubMed  Google Scholar 

  104. Ong KS, Keng SB. The biological, social, and psychological relationship between depression and chronic pain. Cranio. 2003;21(4):286–94.

    PubMed  CAS  Google Scholar 

  105. Miller J, Timson D. Exploring the experiences of partners who live with a chronic low back pain sufferer. Health Soc Care Community. 2004;12(1):34–42.

    Article  PubMed  Google Scholar 

  106. DeGood DE, Kiernan B. Perception of fault in patients with chronic pain. Pain. 1996;64(1):153–9.

    Article  PubMed  CAS  Google Scholar 

  107. Kalvemark S, et al. Living with conflicts-ethical dilemmas and moral distress in the health care system. Soc Sci Med. 2004;58:1075–84.

    Article  PubMed  Google Scholar 

  108. Anderson RA, McDaniel RR. Managing health care organizations: where professionalism meets complexity science. Health Care Manage Rev. 2000;25(1):83–92.

    Article  PubMed  CAS  Google Scholar 

  109. Lefebvre E, Letiche H. Managing complexity from chaos: uncertainty, knowledge and skills. Emergence. 1999;1(3):7–15.

    Article  Google Scholar 

  110. Murphy M, et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998;2(3):i–iv, 1–88.

    Google Scholar 

  111. Ming-Dao D. 365 Tao: daily meditations. New York: HarperCollins; 1992.

    Google Scholar 

  112. TheFreeDictionary.com. Definition: Miss Marple. 2004. http://encyclopedia.thefreedictionary.com/Miss%20Marple. Cited 20 Sept 2004.

  113. Keene A. Complexity theory: the changing role of leadership. Ind Commerc Train. 2000;32(1):15–8.

    Article  Google Scholar 

  114. McKenna SD. Leveraging complexity: the middle manager’s dilemma. Learn Organ. 1994;1(2):6–14.

    Article  Google Scholar 

  115. Smith PA. Implications of complexity and chaos theories for organizations that learn. Learn Organ. 2003;10(6):321–4.

    Article  Google Scholar 

  116. Nixon B. Creating the future s we desire-getting the whole system into the room: part 1. Inst Commerc Train. 1998;30(1):4–11.

    Google Scholar 

  117. Dean K. The role of methods in maintaining orthodox beliefs in health research. Soc Sci Med. 2004;58:675–85.

    Article  PubMed  Google Scholar 

  118. Byrne D. Complexity theory and social sciences: an introduction. London: Routledge; 1998.

    Google Scholar 

  119. Barr H. Collaboration and conflict. J Interprof Care. 2001;15(1):5–6.

    Article  Google Scholar 

  120. Brodbeck P. Complexity theory and organisational procedure design. Bus Process Manage J. 2002;8(4):377.

    Article  Google Scholar 

  121. Willis J. Friends in low places. London: Radcliffe; 2001.

    Google Scholar 

  122. Kernick D. Complexity and healthcare organisation. In: Sweeney K, Griffiths C, editors. Complexity and Healthcare: an introduction. Oxon: Radcliffe; 2002. p. 93–122.

    Google Scholar 

  123. Government of UK. The expert patient: a New approach to chronic disease management for the 21st century. 2002. http://www.ohn.gov.uk/ohn/people/expert.htm. Cited 17 Apr 2002.

  124. Concordance. Welcome to the concordance website. 1999. http://www.concordance.org. Cited 20 Dec 1999.

  125. Fields HL. Core curriculum for professional education in pain: a report of the Task Force on Professional Education of the International Association for the Study of Pain. Seattle: IASP Press; 1995. p. i–123.

    Google Scholar 

  126. Plsek P. Appendix B: Redesigning healthcare with insights from the science of complex adaptive systems. In: National Academy of Science, editor. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2002.

    Google Scholar 

  127. Brown CA. The beliefs of people with chronic pain in relation to ‘important’ treatment components. Europ J Pain. 2004;8:325–33.

    Google Scholar 

  128. Hyde P. Fool’s gold: examining the use of gold standards in the production of research evidence. Br J Occup Ther. 2004;67(2):89–94.

    Google Scholar 

  129. Hawe P, Shiell A, Riley T. Complex interventions: how “out of control” can a randomised controlled trial be? BMJ. 2004;328(7455):1561–3.

    Article  PubMed  Google Scholar 

  130. Jones R. Schism and heresy in the development of orthodox medicine: the threat to medical hegemony. Soc Sci Med. 2004;58:703–12.

    Article  PubMed  Google Scholar 

  131. Ward S. Editorial. The British Pain Society Newsletter 2004;Summer.

    Google Scholar 

  132. Crabtree B. Primary care practices are full of surprises! Health Care Manage Rev. 2003;28(3):279–83.

    Article  PubMed  Google Scholar 

  133. Gillespie R, Florin D, Gillam S. How is patient-­centred care understood by the clinical, managerial and lay stakeholders responsible for promoting this agenda? Health Expect. 2004;7(2):142–8.

    Article  PubMed  Google Scholar 

  134. Elston S, Holloway I. The impact of recent primary care reforms in the UK on interprofessional working in primary care centres. J Interprof Care. 2001;15(1):19–27.

    Article  PubMed  CAS  Google Scholar 

  135. Gordon DB, Dahl JL. Quality improvement challenges in pain management. Pain. 2004;107(1–2):1–4.

    Article  PubMed  Google Scholar 

  136. Main CJ, Williams AC. Musculoskeletal pain. BMJ. 2002;325(7363):534–7.

    Article  PubMed  Google Scholar 

  137. Stacey RD. Strategic management and organisational dynamics: the challenge of complexity. 4th ed. Harlow: Pearson; 2003.

    Google Scholar 

  138. Shaw P. Intervening in the shadow systems of organizations: consulting from a complexity perspective. J Organ Change Manage. 1997;10(3):235–50.

    Article  Google Scholar 

  139. Marinker M. Forward. In: Holt T, editor. Complexity for clinicians. Oxford: Radcliffe; 2004. p. v–vi.

    Google Scholar 

  140. Kernick D, editor. Complexity and healthcare organisation: a view from the street. Oxford: Radcliffe; 2004.

    Google Scholar 

  141. Holt T, editor. Complexity for clinicians. Oxford: Radcliffe; 2004.

    Google Scholar 

  142. Elwyn G, Edwards A, Kinnersley P. Shared decision-making in primary care: the neglected second half of the consultation. Br J Gen Pract. 1999;49(443):477–82.

    PubMed  CAS  Google Scholar 

  143. Bell RA, et al. Unmet expectations for care and the patient-physician relationship. J Gen Intern Med. 2002;17(11):817–24.

    Article  PubMed  Google Scholar 

  144. NHS. Managing the human dimension of change: working with individuals. In: Modernisation Agency, editor. Improvement leaders’ guide, Vol. Series 3. London: Crown Printer; 2004.

    Google Scholar 

  145. The Expert Patients Programme - accessed Sept 2012 at http://www.expertpatients.co.uk/.

  146. Involve accessed Sept 2012 at http://www.involve.org.uk/.

  147. NHS. Achieving real improvement for the benefit of patients: NHS Modernisation Agency Annual Review 2002/2003. London: Department of Health; 2003.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Rehabilitation Medicine, University of Alberta, 2-64 Corbett Hall, Edmonton, AB, T6G 2G4, Canada

    Cary A. Brown F.H.E.A., Ph.D.

Authors
  1. Cary A. Brown F.H.E.A., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cary A. Brown F.H.E.A., Ph.D. .

Editor information

Editors and Affiliations

  1. , Department of General Practice, Monash University, PO Box 3010, Wamberal, 2260, New South Wales, Australia

    Joachim P. Sturmberg

  2. Northern Ontario School of Medicine, Merchandise Mart Plaza, Suite 1212 222, Chicago, 60654, Illinois, USA

    Carmel M. Martin

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Brown, C.A. (2013). Pain and Complex Adaptive System Theory. In: Sturmberg, J., Martin, C. (eds) Handbook of Systems and Complexity in Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4998-0_25

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-4998-0_25

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-4997-3

  • Online ISBN: 978-1-4614-4998-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation