provides a basis for the understanding and treatment of disease, taking into account the patient, his/her social context, and the impact of illness on that individual from a societal perspective. The model states that ill health and disease are the result of interaction among biological, psychological, and social factors. (7)

Chronic pain: Ongoing or recurrent pain lasting beyond the usual course of acute illness or injury or, generally, more than 3 to 6 months and adversely affecting the individual’s well-being. A simpler definition for chronic or persistent pain is pain that continues when it should not. (8)

Cognitive-behavioral therapy: An empirically supported treatment focusing on patterns of thinking that are maladaptive and the beliefs that underlie such thinking. Cognitive-behavioral therapy is based on the idea that our thoughts, not external factors, such as people, situations, and events, cause our feelings and behavior. As a result, we can change the way we think to improve the way we feel, even if the situation does not change. (9)

Hyperalgesia: Increased pain from a stimulus that normally provokes pain. (10)

Interdisciplinary: Refers to efforts in which professionals from several disciplines combine their professional expertise and understanding to solve a problem.

Neuromatrix theory: Proposes that pain is a multidimensional experience produced by characteristic “neurosignature” patterns of nerve impulses generated by a widely distributed neural network—the “body-self neuromatrix”—in the brain. These neurosignature patterns may be triggered by sensory inputs, but they may also be generated independently of them. (11)

Neuropathic pain: Pain caused by a lesion or disease of the somatosensory nervous system. (12)

Nociception: The neural processes of encoding and processing noxious stimuli. (13)

Opioid: Any compound that binds to an opioid receptor. Includes the opioid drugs (agonist analgesics and antagonists) and the endogenous opioid peptides. (14)

Pain: An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. (15)

Pain catastrophizing: An individual’s tendency to focus on and exaggerate the threat value of painful stimuli and negatively evaluate his/her ability to deal with pain. (16)



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