Abstract
Chronic pain is a global health concern. This special issue on matters related to chronic pain aims to draw on research and scholarly discourse from an eclectic mix of areas and perspectives. The purpose of this non-systematic topical review is to précis an assortment of contemporary topics related to chronic pain and its management to nurture debate about research, practice and health care policy. The review discusses the phenomenon of pain, the struggle that patients have trying to legitimize their pain to others, the utility of the acute–chronic dichotomy, and the burden of chronic pain on society. The review describes the introduction of chronic primary pain in the World Health Organization’s International Classification of Disease, 11th Revision and discusses the importance of biopsychosocial approaches to manage pain, the consequences of overprescribing and shifts in service delivery in primary care settings. The second half of the review explores pain perception as a multisensory perceptual inference discussing how contexts, predictions and expectations contribute to the malleability of somatosensations including pain, and how this knowledge can inform the development of therapies and strategies to alleviate pain. Finally, the review explores chronic pain through an evolutionary lens by comparing modern urban lifestyles with genetic heritage that encodes physiology adapted to live in the Paleolithic era. I speculate that modern urban lifestyles may be painogenic in nature, worsening chronic pain in individuals and burdening society at the population level.
Highlights
Chronic pain is a global health concern with evidence that patients are receiving inadequate care, due in part to deficits in knowledge and skills of health care professionals [1,2]
Painogenicity is the sum of influences that the surroundings, opportunities or conditions of life have on promoting persistent pain in individuals or populations [113]
I have used a broad lens to explore a variety of contemporary matters associated with chronic pain
Summary
Chronic pain is a global health concern with evidence that patients are receiving inadequate care, due in part to deficits in knowledge and skills of health care professionals [1,2]. Chronic pain is a biopsychosocial phenomenon, yet pain education for health professionals continues to focus on biomedical aspects of pain [3]. The purpose of this topical review is to précis an assortment of contemporary issues related to chronic pain and its management to reveal the landscape of current knowledge and thinking in the field. I appreciate that the non-systematic approach to review is vulnerable to selection and evaluation biases and opinion-oriented arguments, so I direct readers to key references for comprehensive coverage of topics of further interest. I hope that some of the issues discussed in the review prompts scholarly debate about future directions for research, practice and health care policy. Leder [4], p. 2
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