Wall & Melzack's Textbook of Pain

Pain, Opiates, and Addiction

SUMMARY Over the years there has been a paradigm shift away from the belief that the use of opiates for the relief of chronic pain would inevitably lead to addiction toward an understanding of the complexity of pain relief and…

Hypnotic Analgesia

SUMMARY Modern medical hypnosis is increasingly being recognized as a valid method of pain control based on accumulating evidence demonstrating robust effects on the physiological manifestations of pain-related processes. Besides the operational description of the conditions under which hypnosis is…

Assessment of Pain Beliefs, Coping, and Function

SUMMARY Individual differences in the experience and impact of pain necessitate the inclusion of cognitive, affective, and functional measures in the assessment of pain, particularly persistent pain. A rich and diverse literature documents the role that pain beliefs and attitudes…

Measurement and Assessment of Pediatric Pain

SUMMARY Appropriate management of pain in children depends on valid and reliable assessment and measurement that is implemented regularly and responded to appropriately. Significant improvements in pediatric pain measurement have been made in the past 25 years, and many acceptable…

Pain in Older Persons

SUMMARY This chapter provides an overview of research into pain and aging, including pain assessment and age-related patterns of pain intensity and prevalence. Older people are less likely than younger people to report pain associated with acute pathology, whereas age…

Pain Measurement in Adult Patients

SUMMARY Pain is a personal, subjective experience that consists of sensory–discriminative, motivational–affective, and cognitive–evaluative dimensions. Accurate, valid, and reliable measurement of pain is essential if we are to (1) better understand the factors that determine pain intensity, quality, and duration;…

Studies of Pain in Human Subjects

SUMMARY Studies of pain mechanisms in normal, pain-free individuals provide a degree of experimental control not found in studies of clinical pain and open a window to the experience of pain that is not available in controlled studies with laboratory…

Psychiatric Pain–Associated Co-morbidities

SUMMARY Co-morbidity is defined as “any distinct clinical entity that has existed or may occur during a patient’s clinical course that has the index disease under study” ( ). Co-morbidity is important because co-morbid disease can complicate, interfere with, or…

Cognitive and Learning Aspects

SUMMARY Pain is an experience that affects the entire person; it involves a learning history and occurs within a social context. As a consequence, pain is much more than a sensation or a symptom of a disease. Pain involves not…

Emotion, Motivation, and Pain

SUMMARY There is no more potent a motive in life than to preserve the integrity of the self. Our existence as autonomous agents rests on the ability to detect a multiplicity of dangers and threats and respond to them both…