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It is my pleasure to have been invited to introduce this month’s e-zine for Chronic Pain Ireland. In 2013 I was invited by CPI to speak at a meeting in Croke Park where we discussed "Improving the future for chronic pain patient in Ireland". Eight years on the CPI has grown into a robust organisation presenting the issues, winning prizes and supporting the ambitions of those with chronic pain. Congratulations to the CPI staff and members, past and present, for making it the patient centred organization it is.
Geoffrey Chaucer wrote "Time and tide waits for no man", and neither does pain!  Every month our understanding of pain and pain pathways seems to expand. Some ideas will stand the test of time others will not. But each new idea challenges us to move forward to reach a goal of pain control.
For example, the biopsychosocial approach to understanding pain has been identified as the most successful model to date, in that it encapsulates the broader issues embedded in the interactions among the biological, psychological, and social components unique to everyone. That said, the concept of pain cannot be broken down into discrete physical or psychosocial elements. Indeed, the complexity of pain manifests not only within the range of psychological, social, and physical attributes, but also with respect to chronicity, such that these intertwined components are seen to modulate the patient’s perception of pain and disability.
The biopsychosocial model, therefore, uses physical, psychological, social, cognitive, affective and behavioural measures—along with their interactions—to best assess the individual’s unique pain condition. CPI embodies this approach.
There is also room for other concepts such as the specificity theory of pain, put forth by Maximilian von Frey in 1894, who proposed that there were subcutaneous receptors unique to the different types of sensory input. The distinctions between these receptors varied with respect to their functionality, such that they were designed explicitly to allow for the interpretation of sensations such as touch, temperature, pressure, or pain. We can now begin to measure these sensations and therefore we can try and personalise pain management like never before. Technology and bioelectric medicine can offer the long-term drug free control we strive for so that one day all individuals will have the equal opportunity of a good quality of life.

I look forward to returning to the "good-old days" of in person meetings to enjoy a chat and coffee. For now, I hope you enjoy this month’s edition available to all members.

Kindest Regards,
Dr. Dominic A. Hegarty,

BSc., BMedSc., MB., MSc. (Pain Management), PhD. FCARSCI, FFPMCAI, FIPP
Consultant in Pain Management & Neuromodulation, Mater Private Hospital, Cork
Senior Clinical Lecturer, UCC
Honorary Consultant Guy's & St. Thomas' Hospital, London
Clinical Lead Neuromodulation Research, Tyndall National Institute, UCC
President Elect World Institute Of Pain (WIP)
Clinical Director Pain Relief Ireland

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