Chronic Pain and its Theories

Chronic pain treatment treatment is defined as persistent pain that lasts beyond the expected time frame for tissue healing. Chronic pain can be categorized where the pain lasts for more than 6 months. Acute pain can be defined as pain of less than 6 months of duration. There were different theories of pain since the historical time.

Intensive theory states that pain results from excessive stimulation of the sense of touch. It was said that every stimulus is capable of producing pain if it has sufficient intensity. Specificity theory said that free nerve endings are pain receptors and pain perception is a function of the amount of physical damage only. Strong’s theory suggested that pain was an experience of noxious stimulus and displeasure provoked by that stimulus.

Pattern theories suggested that all cutaneous qualities are produced by spatial and temporal patterns and not modality-specific transmission route. Central summation theory suggested that intense stimulation resulting from nerve or tissue damage activated the pain fibers. Prolonged abnormal activity activated cells in the spinal cord and sent the information to the brain for pain perception. The fourth theory of pain stated that pain had two components: the perception of the pain and the reaction to that perception.

Sensory interaction theory is a description of fast and slow system of pain. The slow system was presumed to conduct somatic and visceral afferents. The fast system was said to inhibit the slow system. Gate control theory helps to account for some of the changes in pain expression and treatment results with its feed forward and feedback loops between central and peripheral nervous systems.

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