Pain Facts

Painology: Acute Pain and Chronic Pain

There are several ways to label pain, here are the most frequently found helpful categories:
Acute pain – begins suddenly, limited duration, usually tied to damage to muscle, organs, bone such as a sports injury.
CHRONIC PAIN is pain that has been occurring for 6 months and is usually difficult to treat. This could include arthritis, Sciatica, SI joint dysfunction, Fibromyalgia, Shingles, and so on. Chronic pain can be from tissue damage (nociceptive pain) but it can also occur due to nerve damage (neuropathy). Another important part of categorizing pain is to consider the social and emotional effects of on-going chronic pain. Sometimes your level of intensity of pain is irritated by feelings about the painful condition itself, feelings such as irritation, fear, stress, anxiety, shame/embarrassment and even depression.
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Costigan (2009) relegated pain into four main groups: nociceptive pain (occurs normally due to painful stimuli, reduces after healing)
Inflammatory pain (results of tissue injury and the
subsequent inflammatory response and reduces after healing)

Dysfunctional pain (provides neither protection from injury nor support for the healing and repair processes)

Neuropathic pain (after damage to peripheral or central nervous system neurons)

******** Costigan M, Scholz J, Woolf CJ. Neuropathic pain: a maladaptive response of the nervous system to damage. Ann Rev Neurosci 2009;32:1-32
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For my take on Chronic Pain here is an article: Chronic Pain: Where Medicine and Psychology Meet
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Many people suffering from Fibro and about 15 to 50% of people with neuropathic pain, such as central pain disorders, experience either allodynia (pain due to a stimulus that does not usually cause pain) and/or hyperalgesia (increased pain from a stimulus that usually brings some pain).

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Recently, some members of the allopathic system (researchers) found they could objectively and empirically distinguish between their patient’s physical symptoms and their emotional pain symptoms by measuring neurological changes in the brain. Astonishingly, some of these researchers demonstrated that some members of the allopathic system (doctors) could better ‘interpret’ pain using mathematics (statistics). For example, Rogachov, Cheng, DeSouza, (2015) report that using the statistical method of Support Vector Machine (SVM) they could distinguish between the subject’s “physical and social pain with 100% accuracy” (Rogachov et al, 2015, pg. 4). For the best coaching practices, this quadrant of science would need to be integrated into the self with other quadrants.

National Institute of Health refers to a study by Bair et al (2003) which also clarifies that not only are there complex psychosocial ties between pain and negative affect but also complex biochemical ties between pain and negative affect. In the context of tapping, in the bio psycho social spiritual system, ‘bio’ usually refers to endocrine and neurological systems.

For example, Bougea, Spandideas, Alexopoulos, Thomaides, Chrousos and Darviri (2013) found that EFT decreased salivary cortisol levels (stress hormone levels) and the frequency and intensity of headache episodes and reduced stress. Furthermore, Andrade & Feinstein (2004) showed a significant change in neurotransmitter profiles from acupoint therapies. Indeed a strong part of the success of tapping (energy psychology) lies in its “involving the chemistry of the brain” (Ruden, 2010, p. 201) although he acknowledged that the tapping techniques are using ‘psychology.’ This agrees with Bark (2011), who accounted for bio psycho social spiritual types of issues in her model calling it “whole body, mind and spirit perspective” (p. 3).

Not only is there ‘overlap’ in the brain between negative affect and physical pain, but the psychiatric “treatments for these conditions are often the same (e.g., antidepressants and cognitive behavior therapy)” (parenthesis theirs, Karp and Reynolds 2009 p. 22). Likewise the tapping treatments are the same as well. For example, “the algorithm protocols are the same for both illnesses” (Gallo, 2005, p. 165) in the Thought Freedom Therapy tapping treatment model, for both pain and depression treatment, even when those symptoms are experienced separately.In addition, other tools can be added such as: herbs, aromatherapy, homeopathy, Energy healing (Healing Touch, Reiki) essential oils, crystals, & incense etc. which would also effect the therapist.

Chapin et al (2014) studied meditation and found a subtle aspect in negative affect (usually meaning depression/anxiety). Her teamalso found brain research suggesting that “effective cognitive and emotional interventions may positively influenced these (brain) pathways and reduce pain” (Chapin et al 2014, p.1). Incredibly, Chapin et al (2014) reports these brain pathways are a major influence of “anger” and other negative affect (disappointment, self-blame, animosity, etc).


Andrade, J. & Feinstein D. (2004). Energy psychology: Theory, indications, evidence. In D. Feinstein,

Energy psychology interactive (Appendix, pp.199-214). Ashland, OR: Innersource Publishing. Bair, M., Robinson, R., Katon, M., Kroenke ... (2011) Depression and Pain Comorbidity. Archives of Internal Med vol 163, Nov. www.medicine.gu.se/.../1453400_bair.pdf

Retrieved 2015
Bark, L. (2011). Wisdom of the Whole: Coaching for Joy, Health, and Success.

San Francisco, CA: Create Space Press Consciousness in Coaching Model Bougea, A., Spandideas, N., Alexopoulos, E., Thomaides, T., Chrousos, G., and Darviri, C. (2013) Effect of the emotional freedom technique on perceived stress, quality of life, and cortisol salivary levels in tension-type headaches http://www.bradburyac.mistral.co.

Retrieved 2015
Callahan, R. (1987) Successful psychotherapy by radio and telephone. International College of Applied Kinesiology, Winter. In Gallo, F. P. (2004). Energy psychology: explorations at the interface of energy, cognition, behavior, and health. (2nd ed.). New York: CRC Press.
Cavanagh, M., Grant, A., Kemp, T. (Eds) (2005) Evidence-Based Coaching Volume 1: Theory,
Research and Practice from the Behavioural Sciences. Australian Academic Press, Sidney Australia.
Chapin, H, Darnall, B, Seppala, Doty, J, Mackey J (2014) Pilot study of a compassion meditation intervention in chronic pain. Journal of Compassionate Health Care
2014 1:4.
Dinan, S. (2014) Consciousness
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Randomized trial of two mind–body interventions for weight-loss maintenance. Journal of Alternative and Complementary Medicine, 13(1), 67-78. doi: 10.1089/acm.2006.6237

Esteve, R., Ramirez-Maestre, C., and Lopez-Martinez, A (2007) Adjustment to chronic pain: The role of pain acceptance, coping strategies and Pain-related cognitions Journal of Health Psychology 16 (5).

Feinstein, D. (2008). Energy Psychology: A review of the Preliminary Evidence. Psychotherapy: Theory Research Practice, Training, 45(2), 199-213.

Foreman, (2014) A Nation in Pain, Oxford University Press IBN: 978-0199837205

Gallo, F. (1999) Energy Psychology: Explorations at the Interface of Energy, Cognition, Behavior and Health 1st ed. Boca Raton FL: CRC Press. In Mason, E. (2012). Energy psychology and psychotherapy: A study of the use of energy psychology in psychotherapy practice. Counseling & Psychotherapy Research, 12(3), 224-32.
Gallo, F. (Ed.). (2002). Energy psychology in psychotherapy. New York: Norton.
Gallo, F. P. (2004). Energy psychology: explorations at the interface of energy, cognition, behavior, and health. (2nd ed.). New York: CRC Press.

Gallo, F. (2005). Energy psychology: explorations at the interface of energy, cognition, behavior, and health. (2nd ed.). New York: CRC Press.

Gaskin, D., and Richard, P. (2011) Appendix C The Economic Costs of Pain and the United States. In Relieving Pain in American: A Blueprint for Transforming Prevention, Care, Education and Research. Institute of medicine (US) Committee on Advancing Pain h, National Academies Press. Washington (DC).

Gatchel, R.., Peng, Y., Peters, L. (2007) The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol. Bull. 133 , 581 – 624. Futuremedicine.com. Retrieved 2015

Grant, A.M. (2003) The impact of life coaching on goal attainment, metacognition and mental health Social Behavior and Personality, 31(3) p. 253-264. In Cavanagh, M., Grant, A., Kemp, T. (Eds)

(2005) Evidence-Based Coaching Volume 1: Theory, Research and Practice from the Behavioural Sciences. Australian Academic Press, Sidney Australia.

Grant, A (2005) What is Evidenced-Based Executive, Workplace and Life Coaching? In Evidence-

Based coaching eds Cavanagh, M, Grant, A, Kemp, T (2005) Australian Academic Press, Bowen Hills, Australia.

Green, S, Oades, and Grant , A 2005 Chapter 11 in In Cavanagh, M., Grant, A., Kemp, T. (Eds)

(2005) Evidence-Based Coaching Volume 1: Theory, Research and Practice from the Behavioural Sciences. Australian Academic Press, Sidney Australia.

Gubbi, G (2012) Research Paper:Spiritual Life Journey – Transformation through Coaching
Posted by icoachacademy | September 21, 2012 By:Gopalakrishna G Gubbi

Life & Spiritual Coach,
INDIA http://www.icoachacademy.com/
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Health coaching and motivational interviewing: evaluating the chronic disease self-management toolbox as a resource for person-centered healthcare. The International Journal of Person Centered Medicine Vol 2 Issue 3 p 520-530

Karp, J., and Reynolds, C. (2009) Depression, Pain and Aging, http://focus.psychiatryonline.org
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Pre-hospital analgesia with acupressure in victims of minor trauma: a prospective, randomized, double-blinded trial. Anesthesia & Analgesia, 95 (3), 723-727.
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Lu, Q, Uysal, A, Teo, I, (2011) Need satisfaction and catastrophizing: Explaining the relationship among emotional ambivalence, pain, and depressive symptoms. Journal of Health Psychology 16 (5) DOI 10.1177/135910530392092.

Mason, E. (2012). Energy psychology and psychotherapy: A study of the use of energy psychology in psychotherapy practice. Counseling and Psychotherapy Research, 12 (3), 224-232.

Miller, W. & Rollnick, S. (2002). Motivational Interviewing: preparing people for change. The Guilford Press, New York. Moayedi, M and Davis, K (2013) Theories of pain: from specificity to gate control
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Olsen, J, and. Nesbitt, B (2010) Health Coaching to Improve Healthy Lifestyle Behaviors:
An Integrative Review. American Journal of Health Promotion: September/October 2010, Vol. 25, No. 1, pp. e1-e12. doi: http://dx.doi.org/10.4278/ajhp.090313-LIT-101

Ortner, N (2015) The Tapping Solution, Hay House New York New York
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Rogachov, A, Cheng, J and DeSouza, D (2015) Discriminating neural representations of physical And social pains: how multivariate statics challenge the shared representation theory of pain.
Journal of Neurophysiology (March 18) doi:10.1152/jn00075.

Ruden, R. (2010). When the past is always present: Emotional traumatization, causes, and cures. New York: Routledge. Salas, M, Brooks, A, Rowe, J. (2011) The Immediate Effect of a Brief Energy
Psychology Intervention (Emotional Freedom Techniques) on Specific Phobias: A Pilot Study
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Unutzer, J., Ferrell B., Lin E., Marmon, T. (2004) Pharmacotherapy of pain in depressed older adults. JM Geriatr Soc 2004, 52:1916–1922, In Karp and Reynolds, 2009 Depression, Pain and Aging,

Wells, S., Polglase, K., Andrews, H. B., Carrington, P. & Baker, A. (2003). Evaluation of a meridian-based intervention, emotional freedom techniques (EFT), for reducing specific phobias of small animals. Journal of Clinical Psychology, 59, 943-966. doi: 10.1002/jclp.10189

Wilber, Ken (2000) Integral Psychology: consciousness spirit, psychology therapy, Shambhala Publications, Boston MA. World Health Organization. (2002). Acupuncture: review and analysis of reports on controlled clinical trials. Geneva: Author. In Feinstein, D. (2008). Energy Psychology: A review of the Preliminary
Evidence. Psychotherapy: Theory Research Practice, Training, 45(2), 199-213.

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One brain and pain article looked for “pain signatures” in the brain. “A brain-based marker of pain might someday help doctors assist people who have difficulties communicating, such as the very young or victims of stroke. ... There are many psychological and physiological ingredients that go into a person's report of pain, and we've discovered just one ingredient here,” he says. Many states of brain activity very likely give rise to pain, Wager adds, “pain is not just one thing.” thing.”http://www.scientificamerican.com/article/neuroscientists-identify-brain-signature-pain/"

Opioid-induced pain sensitivity is noted in the medical literature in both some animals and some humans. In addition, most patients experience the development of Opioid tolerance, needing more and more to help.

Chang G, Chen L, Mao J. Opioid tolerance and hyperalgesia. Med Clin North Am. 2007;91:199-211.

Chu LF, Clark DJ, Angst MS. Opioid tolerance and hyperalgesia in chronic pain patients: a preliminary prospective study. J Pain. 2006;7:43-48.

Compton P, Charuvastra VC, Kintaudi K, et al. Pain responses in methadone-maintained opioid abusers. J Pain Symptom Manage. 2000;20:237-245.

Guignard B, Bossard AE, Coste C, et al. Acute opioid tolerance: intraoperative remifentanil increases postoperative pain and morphine requirement. Anesthesiology. 2000;93:409-417.

Mao J. Opioid-induced hyperalgesia. Pain Clinical Updates. 2008;16:1-4.

Chu LF, Clark DJ, Angst MS. (2006) Opioid tolerance and hyperalgesia in chronic pain patients: a preliminary prospective study. J Pain. 7:43-48.

Compton P, Charuvastra VC, Kintaudi K, et al. (2000) Pain responses in methadone-maintained opioid abusers. J Pain Symptom Manage. 20:237-245.

Guignard B, Bossard AE, Coste C, et al. (2000) Acute opioid tolerance: intraoperative remifentanil increases postoperative pain and morphine requirement. Anesthesiology. ;93:409-417.
Mao J (2008) . Opioid-induced hyperalgesia. Pain Clinical Updates.16:1-4.

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One publication reported that Opioids can cause more pain due to: " While there are many proposed mechanisms for OIH, 5 mechanisms involving the central glutaminergic system, spinal dynorphins, descending facilitation, genetic mechanisms, and decreased reuptake and enhanced nociceptive response have been described as the important mechanisms."

**************Salomons, T. et al (2014) A brief cognitive-behavioral intervention for pain reduces secondary hyperalgesia Division of Brain, Imaging and Behavior—Systems Neuroscience, Toronto Western Research Institute, Toronto, Ontario, Canada Department of Psychiatry. Published by Elsevier B.V.)

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Are you making things worse? http://www.somatics.com/pdf/Might_You_be_Strengthening_Your_Pain.pdf

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For the newest information on Chronic Fatigue Syndrome look up: Elizabeth Haney, MD et all (2015) Diagnostic Methods for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention WorkshopDiagnostic Methods for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Ann Intern Med. 2015;162(12):834-840. doi:10.7326/M15-0443
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__For my take on the science of pain read my paper below:___________________________
Chronic Pain: Where Medicine and Psychology Meet

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