ABSTRACT
This chapter is specifically meant to refer to chronic noncancer pain secondary to chronic soft tissue pain. There are psychological aspects of all forms of pain, particularly when the pain becomes chronic. The neurochemical changes associated with chronic myofascial pain have been adequately discussed elsewhere. However, to further clarify, the changes in the serotonergic tonus, for example, do appear to play a role in depression, as well as other affective changes found in the chronic pain patient. This may help explain why the chronic pain patient may have at least a subclinical depression, many have a more profound depression, and why serotonergic medications are often helpful. Chronic pain can mean so much to a patient that the pain specialist, if he or she does not understand exactly what it entails, may do a significant disservice to a patient by quickly eradicating his or her pain.
