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Chronic Pain Is More Than a Peripheral Event

      Bennett’s focus article makes 2 important contributions: 1 philosophical and the other physiological. “Spontaneous” is, of course, an absurd term to use in the description of a physiologic process.
      • Bennett G.J.
      What is spontaneous pain and who has it?.
      It is reminiscent of another odious term, “idiopathic,” which my grandfather told me was “idiotic for the physician and pathetic for the patient.” If one believes that a process is “spontaneous,” then there is no reason to search for explanatory mechanisms. It has long been recognized that words constrain thought, so Bennett is correct in his attack on this term. Spontaneous generation of organisms or sensations is no longer an accepted explanation of biological phenomena.
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      References

        • Bennett G.J.
        What is spontaneous pain and who has it?.
        J Pain. 2012; 13: 921-929
        • Melzack R.
        • Loeser J.D.
        Phantom body pain in paraplegics: Evidence for a central “pattern generating mechanism” for pain.
        Pain. 1978; 4: 195-210

      Linked Article

      • What Is Spontaneous Pain and Who Has It?
        The Journal of PainVol. 13Issue 10
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          Spontaneous pain is often discussed in the context of both chronic inflammatory and neuropathic pain conditions, and it has been suggested that spontaneous pain, rather than stimulus-evoked pain, may be the more significant clinical problem. The following issues are discussed here. First, it is suggested that the concept of spontaneous pain makes no sense when the pain is the result of an ongoing inflammatory reaction. Evidence is reviewed that indicates that spontaneous pain is present in patients with neuropathic pain, but perhaps only in a subset of such patients.
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      • Reply to Drs. Loeser and Mogil
        The Journal of PainVol. 13Issue 10
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          I thank my colleagues for their remarks and I am pleased that we agree on the usefulness of reassessing our terminology and for the need for research into the question of the role of stimulus-evoked pain and its summation as potential contributors to the pain patient's experience of persistent daily pain.
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