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Pain as a Disease 

Pain as a Disease
Chapter:
Pain as a Disease
Source:
Pain: Dynamics and Complexities
Author(s):

Daniel M. Doleys

DOI:
10.1093/med/9780199331536.003.0008

The foundation and importance of considering pain as a disease is laid out as are the defining characteristics of a ‘disease. Statements from a growing number of organizations and notables including Loeser, Basbaum, Melzack, Leibeskind, Cousins, and Niv supporting the concept of ‘pain as a disease’ are provided. The evidence demonstrating that ‘pain’, particularly is the chronic situation, (a) has its own pathology (physiological/chemical), (b) is independent and self-perpetuating, (c) consists of a constellation of signs and symptoms, and (d) impairs or modifies vital functions, this meeting the criteria for a ‘disease entity’ is reviewed. Chronic pain is viewed from the perspective of a dynamical disease. Dynamical diseases are associated with qualitative changes in the dynamics of an intact physiological system, are studied from the perspective of nonlinear dynamics and can be found within neurology and psychiatry. A dynamical disease is not a result of some genetic predisposition or external event but emerges from a system operating within is own parameters, but which occasionally produces anomalas dynamics. In essence, the disease is embedded in the physiological system itself.

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