Pain: an overview

Until the 1960s, pain was considered an inevitable sensory response to tiss ue damage. There was little room for the affective dimension of this ubiqui tous experience, and none whatsoever for the effects of genetic differences , past experience, anxiety, or expectation. In recent years, great advances have been made in our understanding of the mechanisms that underlie pain a nd in the treatment of people who complain of pain. The roles of factors ou tside the patient's body have also been clarified. Pain is probably the mos t common symptomatic reason to seek medical consultation. All of us have he adaches, burns, cuts, and other pains at some time during childhood and adu lt life. Individuals who undergo surgery are almost certain to have postope rative pain. Ageing is also associated with an increased likelihood of chro nic pain. Healthcare expenditures for chronic pain are enormous, rivalled o nly by the costs of wage replacement and welfare programmes for those who d o not work because of pain. Despite improved knowledge of underlying mechan isms and better treatments, many people who have chronic pain receive inade quate care.