PMID: 9188028Apr 1, 1997Paper

The integration of pain sciences into clinical practice

Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists
L S Gifford, D S Butler

Abstract

In the past three decades, a scientific revolution has occurred in the understanding of the experience of pain. However, a clinical revolution based on the new science is yet to occur. Pain is a multidimensional experience with many contributing and interacting biological/pathobiological mechanisms. These mechanisms may be nociceptive, peripheral neurogenic, central, affective/cognitive or relate to output systems such as the motor and autonomic nervous system. With a better understanding of pain-related neurobiology and some clinical decision making skills, reasoned attempts at a diagnosis of pain can be made. The essential question and first step related to clinical integration is to ask, "what is (are) the predominant mechanism(s) in a given patient's pain state?" This paper provides the underlying clinical biology of pain mechanisms and proposes pain patterns related to the mechanisms.

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Citations

Mar 10, 2012·The Journal of Orthopaedic and Sports Physical Therapy·Robert J NeeMichel W Coppieters
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