Reframing chronic pain as a disease, not a symptom: rationale and implications for pain management.

Reframing chronic pain as a disease, not a symptom: rationale and implications for pain management. Postgrad Med. 2019 Jan 31;: Authors: Clauw DJ, Essex MN, Pitman V, Jones KD Abstract Chronic pain is a common public health problem that has a detrimental impact on patient health, quality of life (QoL), and function, and poses a substantial socioeconomic burden. Evidence supports redefinition of chronic pain as a distinct disease entity, not simply a symptom of injury or illness. Chronic pain conditions are characterized by three types of pain pathophysiology - i.e., nociceptive, neuropathic, and centralized pain/central sensitization -influenced by a cluster of coexisting psychosocial factors. Negative risk/vulnerability factors, e.g., mood or sleep disturbances, and positive resilience/protective factors, e.g., social/interpersonal relationships and active coping, interact with pain neurobiology to determine patients' unique pain experience. Viewing chronic pain through a biopsychosocial lens, instead of a purely biomedical one, clinicians need to adopt a practical integrated management approach. Thorough assessment focuses on the whole patient (not just the pain), including comorbidities, cognitive/emotional/behavioral characteristics, social environment, and QoL/functional impairment. As for other complex chronic illnesses, the treatment plan for chronic pain can be developed based on pain subtype and psychosocial profile, incorporating pharmacotherapy...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research

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I was looking back over the last 8 years since the first Wheat Belly book was released. It’s been 8 years of astounding, truly breathtaking stories of success over weight issues, health, and physical transformations that skeptics even today claim are impossible. It’s been a virtual avalanche of wonderful stories. Although I’ve seen all of them, often more than once, I could not help but be overcome with satisfaction and pride for the many, many spectacular photos and stories people have shared. So I thought it would be fun to re-post a small sample of some of these stories dating back from the start of th...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Wheat Belly Success Stories grain-free Inflammation Source Type: blogs
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Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
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Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
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Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Wheat Belly Lifestyle acid reflux detoxification grains IBS Inflammation joint pain opiates withdrawal Source Type: blogs
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Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Professional topics Research Therapeutic approaches inclusion inequality Source Type: blogs
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Source: Shield My Senior - Category: Geriatrics Authors: Tags: Senior Safety Source Type: blogs
Authors: Clauw DJ, Hassett AL Abstract The mechanisms underlying chronic pain states, including osteoarthritis, differ from those underlying acute pain. In chronic pain states, central nervous system (CNS) factors often play a particularly prominent role. In many individuals with chronic pain, pain can occur with minimal or no evidence of ongoing nociceptive input. Medical subspecialties have applied a wide-range of labels to these pain conditions including fibromyalgia, irritable bowel syndrome and interstitial cystitis to name just a few. These same CNS processes can augment or magnify pain when there is ongoing ...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
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Source: Journal of Sleep Research - Category: Sleep Medicine Authors: Tags: J Sleep Res Source Type: research
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Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Therapeutic approaches Research Pain conditions Coping strategies Science in practice Health healthcare biopsychosocial pain management Source Type: blogs
Summary While research indicates that both the macro‐ and microstructure of sleep may be altered in fibromyalgia syndrome, few studies have controlled for symptom duration or included pain‐control participants (i.e. patients with chronic pain and sleep disturbance not associated with fibromyalgia syndrome). A frequently reported alteration found in the sleep microstructure of patients with fibromyalgia syndrome is the alpha‐delta sleep anomaly. Although alpha waves have been observed during N3 sleep in healthy individuals, it has been proposed that there is an increase in alpha wave activity during slow‐wave sleep ...
Source: Journal of Sleep Research - Category: Neurology Authors: Tags: Regular Research Paper Source Type: research
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