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Pain, Part 2

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What this all means is that chronic pain is multiply determined and that we need to change the brain to change pain.   Pain is associated with emotion and becomes correlated with multiple events that happen in a person's life.   These events become linked with pain and their memory triggers pain.   It's hard to get rid of these triggers without active intervention.   The longer the person has chronic pain, the more triggers develop.   To remove chronic pain, we need to work with these associations and their paired emotions to reduce the triggers.   This is largely psychological work.  




1.   Bennett, R.M. (1999). Emerging Concepts in the Neurobiology of Chronic Pain: Evidence of Abnormal Sensory Processing in Febromyalgia.   Mayo Clin Proc 74: 385-398.


2. McNeely C. (2000). The role of he family in thee treatment of chronic pain. Pain Practitioner,10:5-6.

3. Gallaher, R.M. (2005).   Integrating Treatment in Pain Medicine: Challenges and Opportunities. In Bennett, G.J., Byas-Smith, M., Fishman, S.M., Fishbain, D.A., & Gallagher, R.M. Treatment Advances in Chronic Neuropathic Pain. Advancing Mental Health Expert Opinion Series 1(4) 92-114.


4.   Apkarian AV, Sosa Y, Sonty S, Levy RE, Harden RN, Parrish TB, Gitelman DR. Chronic back pain is associated with decreased prefrontal and thalamic gray

matter density. J Neurosci 2004;24:10410--5.


5. Geha PY, Baliki MN, Harden RN, Bauer WR, Parrish TB, Apkarian AV. The brain in chronic CRPS pain: abnormal gray--white matter interactions in emotional and autonomic regions. Neuron 2008;60:570--81.


6. Kuchinad A, Schweinhardt P, Seminowicz DA, Wood PB, Chizh BA, Bushnell MC. Accelerated brain gray matter loss in fibromyalgia patients: premature aging of the brain? J Neurosci 2007;27:4004--7.


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Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, Coyote Healing, Coyote Wisdom, and (more...)
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