Two questions that patients with chronic pain frequently ask are: “Why me?” and “Why now?” Clearly some individuals are more vulnerable for developing chronic pain than others. A subset of all patients who undergo surgery of any kind develop chronic pain with the lowest rate (5–30%) for simple procedures such as hernia repair and C-sections, an intermediate rate (30–60%) for chest and heart surgery and the highest rate (50–85%) for surgeries involving major nerves such as surgery for sciatica. Between 25% and 50% of patients who develop acute sciatica will go on to develop chronic sciatica whether or not they have surgery. Why is there such a wide variation in whether or not a person develops chronic pain?
Causalgia Spinal pain gate Endogenous opioids Placebo effects Autonomic nervous system Sympathectomy Central sensitization Depression Anxiety
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Suggested Additional Reading
Denk F, McMahon SB, Tracey I. Pain vulnerability: a neurobiological perspective. Nat Neurosci. 2014;17(2):192–200.CrossRefPubMedGoogle Scholar