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Title: Pain
Author: Melzack, Ronald
Katz, Joel
Abstract: Pain has many valuable functions. It often signals injury or disease, generates a wide range of adaptive behaviors, and promotes healing through rest. Despite these beneficial aspects of pain, there are negative features that challenge our understanding of the puzzle of pain, including persistent phantom limb pain after amputation or total spinal cord transection. Pain is a personal, subjective experience influenced by cultural learning, themeaning of the situation, attention, and other psychological variables. Pain processes do not beginwith the stimulation of receptors. Rather, injury or disease produces neural signals that enter an active nervous system that (in the adult organism) is the substrate of past experience, culture, and a host of other environmental and personal factors. These brain processes actively participate in the selection, abstraction, and synthesis of information from the total sensory input. Pain is not simply the end product of a linear sensory transmission system; it is a dynamic process that involves continuous interactions among complex ascending and descending systems. The neuromatrix theory guides us away from the Cartesian concept of pain as a sensation produced by injury, inflammation, or other tissue pathology and toward the concept of pain as a multidimensional experience produced by multiple influences. These influences range from the existing synaptic architecture of the neuromatrix—which is determined by genetic and sensory factors—to influences from within the body and from other areas in the brain. Genetic influences on synaptic architecture may determine—or predispose toward—the development of chronic pain syndromes.
Subject: pain, theories, history, gate control theory, neuromatrix, stress
Type: Article
Rights: This is the accepted version of the following article: Melzack, R. & Katz, J. (2013). Pain. WIREs Cognitive Science, 4, 1-15. doi: 10.1002/wcs.1201, which has been published in final form at
Published: Wiley
Citation: Melzack, R. & Katz, J. (2013). Pain. WIREs Cognitive Science, 4, 1-15. doi: 10.1002/wcs.1201.
ISSN: 1939-5086
Date: 2013-01

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