Objective: In keeping with the best scientific principles, modern medicine hankers after single aetiological agents. In our clinical observations, however, chronic pain is usually the result of many inputs. The objective was to review the etiological theories of pain, with a view to identifying potentially important inputs.
Conclusion: Many potential inputs were identified, including, 1) CNS sensitization following injury, 2) impoverished interpersonal skills, 3) fear of pain and avoidance of movement, 4) care eliciting behaviour, 5) concurrent mental disorder, 6) protracted litigation, and 7) anger toward a wide range of individuals, including doctors and lawyers. In none of the reviewed theories was it necessary that the factor they supported be the only active one. It is probable that chronic pain is often the result of many inputs.
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