Chronic PainDr Steve Gilbert

OUCH!!!

Co-morbidity associated with pain

18

27

33

36

39

55

60

0 10 20 30 40 50 60 70

Poor appetite

Anxiety

Depression

Concentration difficulties

Drowsiness

Lack of energy

Difficulty sleeping

% patients with moderate to very severe

discomfort due to symptoms (n=126)

Meyer-Rosberg K et al. Eur J Pain 2001; 5: 379–89.

Limbic System

SENSORYConscious BrainThinking

AFFECTIVEFeelings

Wind-up and long term potentiationCentral sensitization

Spinal cord

Fear, anxiety, sleep, punishment

autonomic changesLocation rational

“oh bother”

Muscle tightening

Recruitment

Sensitivity

Sometimes – most of the time

feed

back

ALARMS

RESOURCES

• Fife Pain site – www.nhsfife.org/chronicpain

• National Pain site - CHRONICPAINSCOTLAND.ORG 

• Pain Association Scotland & • Pain Concern• The Pain Toolkit is a really useful resource