ABSTRACT
Patients with chronic pain may become inwardly directed and withdrawn. Many chronic pain patients feel that they are a nuisance to others, which serves to precipitate isolation, hostility. There are two basic but arbitrary divisions among therapists in the pain field: centralist and peripheralist. The centralist believes that all chronic pain is merely a memory in the brain’s pain receptor area and that all the tissue injury responsible for the production of the original pain problem is gone by about 6–12 weeks after the injury has occurred. The person with chronic pain is made to feel different from others. The use of opioids or opioid-containing analgesics may be viewed as an antidepressant for some chronic pain patients or for some components of a patient’s pain. When the X-rays, magnetic resonance imaging, electromyography, and other tests are negative, there is sometimes a tendency to assume a psychological basis for the pain.
