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

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RESOURCES

• Fife Pain info - https://sites.google.com/site/fifepaininfo/

• Scottish pain management website - http://www.knowledge.scot.nhs.uk/pain.aspx

• Pain Association Scotland & Pain Concern