ABSTRACT
Astute clinicians have long known that physical trauma, sometimes seemingly trivial, can result in medical conditions characterized by persistent pain (Ashburn & Fine, 1989; Romano, 1990), fatigue (Romano, 1990), frustration, and psychological distress (Aaron, et al., 1997). It is certainly true that most patients who have sustained injuries from motor vehicle accidents, physical assaults, and falls recover fully. At the other end of the spectrum, some individuals die of their traumatically induced injuries. Typically, the clinicians who specialize in pain management do not have the opportunity to treat patients who fall into any of the preceding two categories. It is our responsibility to treat those patients who have neither died as a result of their injuries nor fully recovered. Our patient populations tend not to be composed of cross sections of society but by their very nature are skewed. We treat the patients who have not recovered and probably will not fully recover. Most have already been treated by emergency room physicians, primary care doctors, physical therapists, and other healthcare providers with less than satisfactory results. Our patients complain of chronic pain, headaches, fatigue, and neurological problems, and are often frustrated and angry. This is understandable because many have been injured in either an accident or a physical assault and are often involved in litigation at some level. Although it has been known for many years that numerous individuals suffer persistent pain following trauma (Ashburn & Fine, 1989; Romano, 1990), it is the purpose of this chapter to explain why.
