The complexity of pain: part 2. Pain as a complex adaptive system

Abstract

The perception of pain is regarded as a phenomenon involving sensory, affective and cognitive components. Paper 1 in this series (of 2) reviewed the augmentation of nociceptive sensation in the central nervous system (CNS), concluding that a model of pain is required that unifies these components through the emerging concepts of neuroplasticity and system dynamics.

This paper reviews the connectivity of the CNS, and builds upon part 1 to identify ways in which ‘experience’ modifies and ‘weights’ those connections, promoting emergent patterns of activities in neuronal networks. Pain experience is presented as a feature of a complex adaptive system, with pain states seen as state attractors in a self-organizing system. The implications for physiotherapists in understanding and treating the complex and paradoxical nature of pain are explored.

Keywords:

• PAIN
• NEUROPLASTICITY
• COMPLEXITY THEORY
• NON-LINEAR DYNAMICS