Invited reviewDysfunctional stress responses in chronic pain
Section snippets
Introduction: dysfunctional pain
Many chronic conditions, with or without pain, are qualified by the terms “functional”, “non-specific” or more appropriately “dysfunctional”. Among the best known dysfunctional pain conditions are fibromyalgia, some low back pain syndromes, temporo-mandibular disorders, tension-type headache, irritable bowel syndrome, complex regional pain syndrome, atypical facial pain, burning mouth syndrome, and vulvodynia. Although many were identified recently as separate conditions, they have much in
The adaptive responses to stimuli
Since its introduction in the 1930s by Selye (1950), the term “stress” has become a commonplace concept whose meaning remains vague (Heuser and Lammer, 2003). There are three commonly meanings of the term. The stimulus proper or “stressor”, real or perceived, arises from common life events such as social interactions requiring mental, emotional or physical activity; they modify the homeostasis equilibrium directly or potentially by anticipating what may happen (Selye, 1950, McEwen, 2000). In
Conclusions
Large differences exist in the type of deregulation of the physiological response to stress and lead to pathophysiological differences between pain conditions. There is also much heterogeneity in the dysfunctions of the HPA-ANS systems observed in patients belonging to the same pain groups. These differences and heterogeneities may in part explain the differences in the clinical pictures (Clauw and Ablin., 2009). Complex interactions also occur in chronic pain conditions not only between the
Contributions
Pr Woda designed the review. Pr Woda and Dr Dutheil drafted the manuscript. Dr Picard revised the manuscript. All authors revised and approved the final version submitted for publication.
Funding
None.
Acknowledgement
We are thankful to Mr Jeffrey Watts for his English proof editing.
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