慢性痛への対処法

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  • 外 須美夫
    九州大学大学院医学研究院麻酔・蘇生学分野

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  • How to Deal with Chronic Pain
  • マンセイツウ エ ノ タイショホウ

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Advances of modern medicine and scientific technology have enabled us to appropriately treat patients with pain. However, there are still many patients who are suffering from pain such as postoperative pain, cancer pain and chronic pain, etc. As medicine demonstrates scientific solutions for pain, long human history with great achievements can teach us humanistic way of dispensing with pain. Pain is bound to damage or deformation of body. Bodily damage or deformation, when it continues, can produce deformation of pain maps in the brain, and it may cause deterioration of mind. If central sensitization for pain is constructed, pain cannot disappear but gets worse with the vicious circle. Neuroplasticity works originally to recover from damage or deformation to normal condition, whereas it can move to the opposite way through the vicious circle. In order to treat chronic pain arising from deformation of pain maps in the brain, it is important to try inner plastic alteration of the brain, especially at the prefrontal cortex where pain recognition is produced and the insula cortex where bodily information and emotion are monitored. By cultivating neuroplasticity of those brain areas, it becomes possible to change a negative mood to a positive one, and desperation to hope. In addition, adjustment of the motor cortex is useful to treat a certain type of neuropathic pain since it is closely related with the sensory cortex. In summary, we should utilize not only the scientific power of medicine but also the healing power of the brain and mind using all humanistic approaches such as mindfulness and meditation, etc. to deal with persistent pain. Holistic treatments for pain beyond the brain will also make it possible to elicit the alleviation of pain itself and also the sympathy and compassion for peoples suffering intractable pain.

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