Four Steps in the Evolution of Chronic Pain

There are four primary steps in the evolution of chronic pain:

(1) There is a source for the pain, which may or may not be readily identifiable

  • Structural–identifiable lesion with MATCHING symptoms
  • Non-structural–inflammation or irritation of the soft tissues, which cannot be seen on a test
  • Mind Body Syndrome–the nervous system can spontaneously cause pain without an identifiable source

(2) The brain becomes sensitized to the pain impulses

(3) The nervous system memorizes the pain

(4) Emotional factors alter the pain experience

  • Sleep
  • Anxiety
  • Anger/frustration