ABSTRACT
What is maldynia? As originally dened, it is intractable, chronic pain (1). This is a valid denition, but one that I believe leaves considerable room for speculation about what such pain involves, and why, how, and in whom such pain occurs. Such conjecture must acknowledge the biological, psychological, and social dimensions of both cause and effect. Maldynic pain is not merely chronic pain; there is a natural history and purpose to chronic pain. It engages a hierarchy of physiological mechanisms that promote rest, repair, recuperation, recovery (ideally), and, it might be argued, resilience (2). Perhaps, this might be regarded as wild-type chronic pain-a process through which the organism recuperates and recovers, or if not, succumbs to the ravages of progressive pathology (caused, at least in part, by alterations in the immunological and endocrine systems), loss of social conjoinment, or predation.
