The stress and strain of pain

Abstract

AbstractThe definition of stress is briefly discussed, and a plea is made for scientific consistency in terminology. Operational definitions of stress and strain are provided. The physical and psychological components of pain stress are then examined, and pain stress is held to comprise the complete process from onset of tissue damage or other noxious condition to the experience of pain itself. The pain‐gate theory as an explanation for the psychological anomalies of pain is briefly described. A distinction is then made between conditions of acute and chronic pain: the former presents with a pattern of anxiety, while the latter matches a psychiatric depressive condition. Chronic pain and depression are inextricably interwoven and interactive, and exist as a discrete and identifiable syndrome. Psychological pain management techniques have a minimal part to play in the treatment of acute pain, but become of increasing relevance and importance as the duration of the pain increases. Various types of psychological intervention for pain relief are listed, and it is suggested that the psychologist's most useful role is that of detailed comprehensive appraisal of the pain patient and the planning of a programme of psychological treatment specific to the individual concerned. Such therapy to reduce pain stress and eliminate pain strain can then be carried out by appropriate trained health care workers under medical supervision.