Pain theory Acute and self limiting pain, the sort that hurts and then gets better with time after an injury or an operation is perhaps more easily understood by an anatomical model which plots the pain ‘wiring system’. We now realise that these ‘connections’ may be formed by nerves, chemicals and tissue reactions to injury and represent the ‘Descartean view’ of pain based on a simplistic linear theory. The widely accepted theory of pain production and maintenance in chronic pain conditions, where pain is present for more than 6 months, includes three associated, interrelated and interdependent aspects as outlined by Engel in 1977. Thus the  bio-psycho-social theory of was proposed and underlines the complexity of chronically painful conditions. The biological aspect deals with the physical process of pain production and the changes within tissues and the nervous system over time as acute pain becomes more chronic. Psychological considerations become increasingly relevant and influential over time with a degree of pain dependency being evident with chronic pain. Social interactions have a significant influence on how we all manage chronic pain conditions and to what extent pain affects our lives, and the lives of those around us both at work and at home.
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