Papers of the Week

Pain is often the initial complaint for which patients seek medical care presenting both a diagnostic and therapeutic challenge to the primary care provider. The appreciation of pain is not merely the result of abnormal sensory stimulation causing an unpleasant sensation but rather a combination of the recognition of the somatic discomfort in association with an emotional response to that discomfort. The perception of pain and the extent of distress and disability can vary depending on previous experience, cultural background, situational factors, and comorbid psychiatric disease. While acute pain is usually the result of tissue damage, that is not always the case as evidenced by the primary headache disorders. Chronic pain may be the result of an injury, irreversible underlying disease or clinical conditions such as fibromyalgia for which the mechanism remains unclear. Treatment of the underlying cause will usually effect a resolution or improvement in the pain but when the discomfort persists a consultation with a neurologist or pain management specialist should be considered.