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The Diagnosis and Psychophysiological Management of Chronic Pain and Anxiety

  • Ian E. Wickramasekera

Abstract

There is a growing awareness that the parameters of acute and chronic pain vary widely. Acute pain is easy to localize and recognize, and may, in fact, be mediated through different pathways from chronic pain (Sweet, 1981). These pathways include the (a) dorsal-column post synaptic system (DCPS), (b) spinocervical tract (SCT) and (c) neospinothalamic tract (NSTT), which are all rapidly conducting systems suited to convey phasic information (Melzack & Dennis, 1978). Acute pain is marked by an increase in mytonia, heart rate, blood pressure, skin conductance, and peripheral vasoconstriction together with other indicators of sympathetic activation. From a psychological or behavioral viewpoint we are seeing the same signs that indicate fear or anxiety. Chronic pain has been defined as any pain that has persisted for over 6 months and has not responded to standard medical management, including drugs, physical therapy, and surgery (Sternbach, 1974). Bonica, a pioneer in the study and therapy of chronic pain, defines it as “pain which persists beyond the usual course of an acute disease or a reasonable time for an injury to heal, or it recurs at intervals of months or years (Bonica, 1980). Studies by Johnson (1978) and Barton, Haight, Marsland, and Temple (1976) reveal that 75% of patients who complain of recent onset back pain experience spontaneous remission within 3 months.

Keywords

Chronic Pain Acute Pain Pain Behavior Chronic Pain Patient Tension Headache 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Ian E. Wickramasekera
    • 1
  1. 1.Behavioral Medicine Clinic and Stress Disorders Research LaboratoryEastern Virginia Medical SchoolNorfolkUSA

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