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Introduction

What was the worst pain you can remember? Was it the time you scratched the cornea of your eye? Was it a kidney stone? Childbirth? Rare is the person who has not experienced some beyond-belief episode of pain and misery. Mercifully, relief finally came. Your eye healed, the stone was passed, the baby born. In each of those cases pain flared up in response to a known cause. With treatment, or with the body's healing powers alone, you got better and the pain went away. Doctors call that kind of pain acute pain. It is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself.

Chronic pain is different. Chronic pain persists. Fiendishly, uselessly, pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap-a sprained back, a serious infection-from which you've long since recovered. There may be an ongoing cause of pain-arthritis, cancer, ear infection. But some people suffer chronic pain in the absence of any past injury or evidence of body damage. Whatever the cause, chronic pain is real, unremitting, and demoralizing-the kind of pain New England poet Emily Dickinson had in mind when she wrote:

Pain-has an Element of Blank-
It cannot recollect
When it begun-or if there were
A time when it was not

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