title: Pain perception in the older patient. Using the pain hologram to understand neck and shoulder pain.
abstract: Pain is a common complaint and its perception is a complex issue. The older person with neck and shoulder pain may have contributions to that pain from multiple and diverse sources. These can range from nociceptive stimulation, neurologic sensitization, emotional issues, socio-cultural biases, cognitive interpretation and meanings of the pain to that person, concurrent medical and psychiatric illnesses, and memory (both pain and non-pain related memories). The affective dimension of pain can be more influential on a person's ultimate pain experience than the sensory-discriminative component, and both must be understood for each patient, in terms of it's relative weight in each pain. Neck and shoulder pain can represent eudynia and maldynia, or concurrent existence of both. To properly treat patients with this complaint, physicians must understand what comprises each individual's pain hologram and direct treatment at as many component parts as possible.
authors.affiliation: University of Miami Medical School, Miami, FL, USA.
authors.forename: Albert L
authors.initials: AL
authors.lastname: Ray
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D020069:Shoulder Pain / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology