Chronic Pain


pain, unpleasant or hurtful sensation resulting from stimulation of nerve endings. The stimulus is carried by nerve fibers to the spinal cord and then to the brain, where the nerve impulse is interpreted as pain. The excessive stimulation of nerve endings during pain is attributed to tissue damage, and in this sense pain has protective value, serving as a danger signal of disease and often facilitating diagnosis. Unlike other sensory experiences, e.g., response to touch or cold, pain may be modified by sedatives and nonsteroidal anti-inflammatory drugs or, if unusually severe, by opioid narcotics. Recently, patient-controlled analgesic techniques have been introduced, in which patients have the option of injecting small quantities of narcotic type analgesics to control their own pain. Microprocessor-controlled injections may be made through intravenous catheters, or through a catheter into the epidural (covering of the spinal cord) area. If such treatments do not suffice and if the cause of the pain cannot be removed or treated, severing a nerve in the pain pathway may bring relief.

Pain is occasionally felt not only at the site of stimulation but in other parts of the body supplied by nerves in the same sensory path; for example, the pain of angina pectoris or coronary thrombosis may extend to the left arm. This phenomenon is known as referred pain. Subjective or hysterical pain originates in the sensory centers of the brain without stimulation of the nerves at the site of the pain.

Progress has been made in the management of chronic pain and in the education of patients and physicians in such techniques as biofeedback, acupuncture, and meditation and the appropriate use of narcotics and other medications. Using advanced medical-imaging technology, researchers have now located multiple pain centers in the cerebral cortex of the brain, offering promise of possible improvements in measuring and managing pain.

See F. T. Vertosick, Jr., Why We Hurt: The Natural History of Pain (2000).

The Columbia Encyclopedia, 6th ed. Copyright© 2014, The Columbia University Press.

Chronic Pain: Selected full-text books and articles

Treating Chronic Pain: The Healing Partnership
Aleene M. Friedman.
Plenum Press, 1992
Handbook of Pain Syndromes: Biopsychosocial Perspectives
Andrew R. Block; Edwin F. Kremer; Ephrem Fernandez.
Lawrence Erlbaum Associates, 1999
You Don't Need a Hysterectomy: New and Effective Ways of Avoiding Major Surgery
Ivan K. Strausz.
Perseus Books, 2001
Librarian’s tip: "Chronic Pain States" begins on p. 231
Soothing and Stress
Michael Lewis; Douglas Ramsay.
Lawrence Erlbaum Associates, 1999
Librarian’s tip: Chap. 10 "Soothing and Chronic Pain"
The Anthropology of Medicine: From Culture to Method
Lola Romanucci-Ross; Daniel E. Moerman; Laurence R. Tancredi.
Bergin & Garvey, 1997 (3rd edition)
Librarian’s tip: Chap. 12 "Narratives of Chronic Pain"
Advances in Personality Assessment
Charles D. Spielberger; James N. Butcher.
Lawrence Erlbaum Associates, vol.7, 1988
Librarian’s tip: Chap. 7 "Assessment of Anxiety, Depression, and Anger in Chronic Pain Patients: Conceptual and Methodological Issues"
Attitudes toward and Knowledge of Chronic Pain: A Survey of Medical Social Workers
Sieppert, Jackie D.
Health and Social Work, Vol. 21, No. 2, May 1996
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
The Illness Narratives: Suffering, Healing, and the Human Condition
Arthur Kleinman.
Basic Books, 1988
Librarian’s tip: Discussion of chronic pain begins on p. 57
MacDonald, Judy E.
Health and Social Work, Vol. 25, No. 1, February 2000
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Understanding Chronic Pain
Angela J. Koestler; Ann Myers.
University Press of Mississippi, 2002
Under the Medical Gaze: Facts and Fictions of Chronic Pain
Susan Greenhalgh.
University of California Press, 2001
Pain: Psychological Perspectives
Thomas Hadjistavropoulos; Kenneth D. Craig.
Lawrence Erlbaum Associates, 2004
Librarian’s tip: Chap. 8 "Assessment of Chronic Pain Sufferers") and (Chap. 10 "Psychological Interventions and Chronic Pain"
Presurgical Psychological Screening in Chronic Pain Syndromes: A Guide for the Behavioral Health Practitioner
Andrew R. Block.
Lawrence Erlbaum Associates, 1996
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