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    Kulid3991h 1

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    adga rwerwe
    Headaches are one of the most common medical complaints worldwide. They represent a significant source of pain, discomfort, and disability for many individuals. While headaches are usually self-limiting and not indicative of serious illness, they can greatly reduce quality of life. The experience and understanding of pain, including headaches, has evolved considerably over centuries from early Greek and Roman concepts to modern biopsychosocial models of pain that recognize both biological and psychological factors. Current research continues to explore the complex interactions between genetic, environmental, and psychosocial factors that contribute to headaches and chronic pain.

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    © All Rights Reserved
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    Kulid3991h 1

    Uploaded by

    adga rwerwe
    413 views100 pages
    Headaches are one of the most common medical complaints worldwide. They represent a significant source of pain, discomfort, and disability for many individuals. While headaches are usually self-limiting and not indicative of serious illness, they can greatly reduce quality of life. The experience and understanding of pain, including headaches, has evolved considerably over centuries from early Greek and Roman concepts to modern biopsychosocial models of pain that recognize both biological and psychological factors. Current research continues to explore the complex interactions between genetic, environmental, and psychosocial factors that contribute to headaches and chronic pain.

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    kulid3991H-1

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    Headaches are one of the most common medical complaints worldwide. They represent a significant source of pain, discomfort, and disability for many individuals. While headaches are usually self-limiting and not indicative of serious illness, they can greatly reduce quality of life. The experience and understanding of pain, including headaches, has evolved considerably over centuries from early Greek and Roman concepts to modern biopsychosocial models of pain that recognize both biological and psychological factors. Current research continues to explore the complex interactions between genetic, environmental, and psychosocial factors that contribute to headaches and chronic pain.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    413 views100 pages

    Kulid3991h 1

    Uploaded by

    adga rwerwe
    Headaches are one of the most common medical complaints worldwide. They represent a significant source of pain, discomfort, and disability for many individuals. While headaches are usually self-limiting and not indicative of serious illness, they can greatly reduce quality of life. The experience and understanding of pain, including headaches, has evolved considerably over centuries from early Greek and Roman concepts to modern biopsychosocial models of pain that recognize both biological and psychological factors. Current research continues to explore the complex interactions between genetic, environmental, and psychosocial factors that contribute to headaches and chronic pain.

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    Pain

    nosl

    CENEA,AI INTRODUCTION
    6 ,H6d&he reF6@1s o.e ofth.

    h d ofthc gs14l hme xpdien

    guat

    hlM di!ffifofti,

    ils

    signjfd@

    ono alstru.

    is

    for it

    tuv sietd

    t6id d f!tigu.. FdtDrt ly it tusr i61at6 it


    rcndr th llter ed o.ly Gxeptimally do* it wm of { intd ffial ab.@.liiy but it
    sdioB

    is

    di!$ d rlr6dr

    only

    fl.litot

    thi! dud si8lin@cq th. boigD dd lhc poldtially

    alst'{H!ns.,

    Dhy3iciD rnd the ibdalist on th.

    Had.che

    r.

    drerdd

    into populalioN which have

    hsdlchc

    lirtd

    s,

    sMied,

    rhfr

    hug

    disd6

    still

    @f@e it

    wdldwidc

    ddryndq $ct rta.l@

    sfsing

    6mci.l

    p.liqt pd ycs, R.@chd

    hadehe

    bu only

    bd

    2005)

    dnd disability whicb is

    iDpos EBI buda wHo bilrtite b

    wirh drsabiliy,

    4500 pr
    bDt

    ubiquitou &d

    aDd

    in

    havc

    ro

    S-

    ys

    nft

    of

    lif.,

    sl ofce b ovf
    wqld i3

    @{in u@nqud.d,

    1988 @ncluded

    lbd niSniE b

    udddi!8!o*4 tbda rrstd

    do t@ized 4 a dis@

    son @utrrd ledach dierdd m tul

    it R6e$

    which de so

    .esd bv

    *ully b@ done in thc d*1oped

    inro Hadacnc it

    thqe is

    .xcili4

    I ldg. g!9 b.tw6 ...d

    ofgrlinto.lse if

    ud.rnood ed etrdiv. rrfidts rDd. avil.bl. hoead


    l5

    is oborc 9@Z

    f it th. qls ofyd

    @rtq in lbe U

    s selflimitirg dd dintondl slbptodq

    @ ed !ct*

    that shornd k? the

    1he

    !o

    diedd

    6cd,

    schizophmi. bll is . Dajor prcbld Pho oBidet d F@

    poilt of

    vjq. h oft lsec swEy il vs foud

    to be

    oE of

    oft.qu@ct, for *hich itdividEls 3..& oulPctiat m.di@l


    l9?5). tn s sui!y of@mplainrs,
    a

    or

    . F. plid n.dicd

    dd

    liv6 ofur.

    likc 6 hdn

    thc top 14

    w.

    ta

    adve6 t!rd. oq l.sr

    in ih. ddloPcd votld do tu1 iolch on lh.

    .HedelE b t ni@r
    Foblo vha @nped

    @nplain! (lpviloq I98?), ln

    is io

    fs

    di54.'

    Aideniologic

    lmhlds ir tms

    (D.LoziF ud

    it wq tn. third

    swey of |he gdefl poPulation 6tiDala

    G.ltorl

    nct tcqml

    tu

    froh

    14%

    ofmale md 28% of fddcs qiih A.qud $d dist6sing beadachB io


    .14!d

    offan le

    wirh

    orc b.lf(52%) of

    16r

    sv@ h.rd..h6, A.d.$*, HoltDy( & Ab.ll,099) fo$d ovd

    ltts.

    @1169.

    studat Dotdltio. adoinql !o bwin8 ban'.!s,

    Eittorial Rqi.|9
    'fn. hisbry ofhad*hc dlrd

    di.Lne

    of

    hdd.dc h fou.d

    itr ih

    t{.t

    ro

    1a dFus.ld

    ofmgj.d fonuls vbicb *@

    @nDriliDg

    It. lan H.rMit


    dd

    capp.docia

    is

    cl$icd deiotioi ofthc


    nisFin , C.l'iu

    ws @i!.d

    ond d.diLd

    tm

    ofold

    found in

    or

    by

    b@*

    re|w

    hisgd of

    |@slnz.d 6 9Di6l

    dudity (dy5p.9io, or old)


    (200

    ofhis

    han

    A,D)i

    offE d rh. M"-

    Hmi@ia

    th

    Enelisbsqd'M.srin"'!dth. FMc!vord Mi8tu. "Th. idathrl

    IMtq,

    D6l inrdErins

    is

    A fcw

    foui

    of Bing4 (109811?9)

    (600

    a.D). DDng

    nr

    follovld

    into bllck oals,

    on

    deiptid

    in d! wndnSs

    ii.

    .g@t3 ws Pur

    hdo

    D.lc sufr@,

    of lh. disddd

    pith jl

    drb*ld

    and

    rorv

    da

    foddd

    bv

    l!.

    ed nedi.rr

    thoueh

    wom wilh

    it slrm ih@e! @

    of

    tlc

    ofdc l2t @luv Attb6., &d nvslic, Uil&rtd

    pMably dsiung ! DiSEinc M4

    eil beutitul, ttd

    whicL tbe

    A.D

    Atsdlx r pntti.io in El a-D. in

    d6dib.d v!.r

    dooiptior ofbadach.!, h.v. fotued

    splddid

    & iD

    8i.!had btw@ 150C1800 Bc-

    wd c,hsg.d to Hdidei. by cald

    cc.k phy.icid", Pdl of^.gi.a

    out

    ndv @lh6 .

    tb. "dh@vm ofmigarc tri88d

    stldly

    (215-3oo)

    hrd

    Alhd.v.d4 wi$o i! 8l

    hd.ci6 Fnr noh btb o6sN ra5io! dd h@anl

    oigd!.

    of

    Dqe,

    @ndijob. .rd hc d66ib.d th 16 qu&3 ed

    misEin. eiSep6 &intitrg winc


    Th

    y@ d

    drii6t mcdidd l@rds

    Brbybnu Arcth6 rcfcg@ lo ne.d..h. k

    disi!

    ofnal4 &

    n twie ! w*k

    on@

    1.r,

    310/0

    qcadilrly

    dd suddaly

    Dultitlldc

    tbcy

    r.w ! 8t@l

    off.llits

    star' Dos:t

    spels, wiol

    e@ sll @ihjl.Ld hciry lut d

    ed .!!i into lh. 6yss, s th.t I odd

    s ind no hre"

    T16 @ woal

    6nri6

    shep

    ss a clstd

    intElnot

    to l{ out

    clslor oil plel ws

    hadlch. suffdd

    ha<bcls wLi.h

    qt

    nr

    dd

    ch.Iff

    wil

    spinl which

    @ in!.d

    itElnai ofh.rd&h6

    today in th.

    pon

    .rd dolq,

    lnCle J,

    l;f

    dismforl, disEs d
    Th.

    tdn

    p6in

    l@tilS
    s

    ways. H..d pxn is a vdy dislur6i4

    Pdn h

    tlE

    i5

    diml

    qjsloe

    Pdr is

    of

    with Dy

    '5!u6

    or

    Des to

    ls

    ovitlMat

    4d Poaltv"

    "uish

    localial 3.!e!tion of

    s lMy f@s

    f..Me

    aild

    rde 6diig

    ftdifBl

    diff@r

    in

    dd m tX pd.ding

    P.in is "Onc of natrc's

    th

    Pffi

    undd8ping

    il

    @liei

    6qy dpaid6

    bv

    sigru

    of

    *dic! bufu'3

    djla*.

    e indili@ ml a disa*

    inldity.

    lh 6rst boor on

    Ltb vitll lign

    d@8!r tll i!.

    psdo di!@., b i hd a etuEl


    lo@tion dd

    F !cloa

    Disrdd '

    ! mE

    oeplcit.ting

    biv.nd apdi6e.

    Borbidity" ed il

    Faiv.

    Ci@k-

    6oE th. stimuldio of spei.lizd


    ir

    P.cifc.

    aid by rurrbing Oa for.had

    sil6l dibdio. dd @bB ed ov@helm

    iow ii hs b@ l@sdzed a

    the Sou$

    in 1600 B-c ln

    Latin word "P@m" whicb

    b r cqaciG rubric

    qpdi@@, It b

    hole in lh. skuu with

    tiFh tib, Livciig ( l8?3) tublish.d

    Ic (2002) dfiD6 pai!


    aony

    rt@aricnqd&bc

    had.che, "M.gim, Sict-Heid.che &d sonc .ili.d


    P.in i! ddived Aon

    Fs.dG ed

    |g6dv ir

    liu

    edd s.& F[f by chaiDg CiMg


    hed, @iot@y fd

    e disirg ton

    $rEil

    lo

    of ir@hiling which involved m!&ine

    usd in the

    with th. p.ln ofth. n8!t


    minor

    for

    tu8ing Am hedbmds, lakinS of hdb!,

    Th@
    a

    cltEl tEeoll

    Pain

    bur

    ovd tltc

    history wh'ch b not like

    Bperally h.!d.c,he @ .

    Th. nody

    vG

    66

    liic pliD b

    ry

    it ba acquircd isnE

    mle

    paits whicb ha

    for help tbal I

    all $. tmi

    thal

    of

    lihild

    not @ping

    emaling

    is

    wtrg.

    Pain

    paii

    vai.s in intdity dd level, sudda ir&rlc pain is

    called

    &ut pd! ed p6isl6l

    is cdld chrcnic pain.

    Phloepb6lit
    dmlin

    .n<l wnnin rh.

    rh !.i!

    Arislod. sla6icd

    dould

    be

    aiw.d 6 d doti@

    ofrbe Dird nlha rhb thc physicd tody'. the philosop[d

    pDpo6.dOdsilelh.tainwsloc.lcdin$.Dndnstdddt ov@cilmugh
    sd ndoraic". Religlc ladqs vid.d

    trsrndrs. sme
    ba.uc

    ws sot

    r!!t ir wa

    $s8Es1d

    6 puislmdi

    by God

    a b.yoid

    pdn

    popa

    lhc

    sp.

    for Dcdicd

    ofpb{ic5l

    p6ditid6

    for th. irdividuds Sin

    1o8ic

    ro

    irdl

    Pain

    Original Sjt".

    (Milla,1983).

    Physicis vjqd pai. d saery

    oe h ry,

    LilmtN illoE u

    !frtjlc 6poa. toFrid.d

    r,r. T,.o.ditl Rai.t


    Tnui6 hlvel,
    qFdsior

    of

    sts

    phmh4

    rh.l prin i!

    d[r

    iNlc

    e d8&ic

    which is Utld snn

    a dotioual apsioe ud
    th.

    mrnic,

    @gnitiv ud

    mtiond

    otEanbAa
    popos.d to apLiD

    psydologic.l

    ua$"

    ha

    p!in.

    P.jn

    $frdire 6 a Dod. of

    t@griz.d *ith

    publiafo! of @.

    th

    studid of pstidts eilll Hyst@a, (B@6 & F@d, I 895). Engle ( 1959) rcpuLd or
    gbup of (P.in pon

    p!tiat') vho dppdr.d

    punishsor. Childhmd Elltjonshjps h!v.

    !!trair& h sme

    with alidn

    of!ffEtio4 in oihd

    disphy'

    sfdirs

    is

    In

    ..s

    'ring

    ba

    olt lain 4

    fi. anaclm.'r
    d*elops

    adion by th. cm

    psots h.d

    ofself

    @ld ald rcj.{ring. P.in

    def.nsiw lubtitul. fot ov.rt

    givm".

    fm

    h6h chstiMal ald ovd ompastilg

    nodl pbpos.d by Borlby, 0 %9)

    s.

    charlcldiz.d by aggrsion and

    Ffletiv. ofp.yc!.logrql di6culti6 digjnari.S

    ird.Fndd

    refdt

    to 3..|(

    .!d chonic

    in cnildno.d".

    !6ti6ts ptef@@

    dislr*

    fd

    in o.dq to avoid

    Tdr

    ard no.

    984)

    h.E l.bel.d a dialh6is -s!s nDd.l. Tfc

    which $et

    6ulls ton

    ''cJmnic pain

    Fi4

    h.v. prcpc.d . bio Fych@i.l Dodel of chuic

    dE intd(*ion of

    dgeic d Fychological @nditior

    Mption

    of rhis mod.l is thlr

    avireMdtd .6is eilh t pttdisposi4

    It.

    o. diath6h.

    dg&ic

    fa!6

    or psy.hologicd

    oDprising $e diall)sis may vsry fom indivjdlsl to inditdud, .9. lil phtsical build

    bal$

    int@cts with

    rtuj@

    Tnn

    @md
    lh. pain

    iMe

    ir

    cmot @!. l@&

    xFi6e

    ilchdia

    r.las

    of

    6iop6ycLMi.l nodel isl6

    Fychologic.l

    rnd

    pic6$

    lo th. th6!F

    tt D.pt.ssiotu

    lhc

    nusld

    P lhal

    will

    it the

    cse

    hdddit!.tron l r.lftimshiFt

    avitumo.d hcr6 it

    fo.|g

    ofd.

    on

    thc

    qpleari@ of

    b'ologi.d

    pl\)6s ad

    nin<!, tb. biopsyc[owial nodel

    /avircMatd

    factoB

    caMlb. s.p@lst

    Hms bnSs spel

    of poin

    i.

    bioloaiql, prycholoecd, ed

    r2.r. P.i,

    in

    dd

    .eflex span

    bnditind sbs&te

    .@ur

    into

    disds. \vhe@ a bim.di.tl hodcl of dis.e

    that

    s in@

    itjury

    if the @@tralior is luffciddy hi8h".

    bdw6 tlFologiol, bdEvionl,

    sts

    io

    neuld ttubn lad! to iscndi4 euine

    aR4 long hslirg

    Tbe

    like

    pt.d'sposilg di.lb6i! l.adiry to a @nplaint of Pain. Enotional

    physi@l facld wnn which th. indiudlal

    laE

    Bt

    positjon .nd lsycholoacal conditioniig. Tl'c spaific phyd@l

    my

    w!ts,

    btlr tbe

    "ldclagc ofdpEsion @ nimr tl'.l4slagc of p!in" D.pNion wok* cbrcnic


    p6in by

    b@sing p.in ssitivity dd lowaing

    parn

    tolm* thEhold A@rding lo

    Bluq&Hilhom(1982)edEng.l (1959)"cltonicPainrcil.t .nul.ddlBsire


    dlle in a tair prc!. ildividull
    vllicn nay
    ''An

    nskcd

    or

    th6t ie pain

    fry

    vdi&t

    of !

    nay b!

    oltdt h,loll6is

    thy sb@ a

    pDductiotr of

    c)M

    b lhai

    pl.su @.tic.l" (Misui,

    bdif6irtion

    of

    d?rsive

    sLt,

    d.pr6!iv. lPelrM dierdei'

    clM'c

    prthephysiolo8/ fd

    pain A

    d@Bion

    oq

    sinultan@Bly

    qmPl., Smlodn defciacy d

    198?).

    er6irc

    Sdall

    studi6 have irdicstcd

    be

    mst Fwd6t .rd difiorlt Fobld

    seqlel& . tusativc f.cior or a nodiryins f.dor in pain. Clmnic p.in

    ed depBsion hs

    6n*udrp6i, ed th.

    l@d to a

    lhFicia tEr

    @!t!vary Egddite

    Scved sndi6 h.v. indrqt d r

    wsity

    of

    Mta

    tbe rcl.donsbip

    ds $ppql

    of d.prBsior and $gs61d lhat ih@ is s nis!

    ii hadich6,

    wiih dalirticd

    *Eity of

    lb.

    l963a Fn6, Spilz

    th.

    &

    vi4 rbtr'l'.id.clc

    prvaloe

    sigrif@ b.t*@ sFplms

    me of

    betw4 th.!e tso

    rtds Miation hwd

    ld (|990)

    tu

    o(::llt!!E ofFin

    T1. bjeD

    d.pBive s}[pbmtobsr'(Bhdl.y!

    CtE& MyDs; KEyUll& Don


    6

    d?ssi@. 'D.prsio'

    Elalionship ofp3it &d

    is

    of d@G.ion (63'l")

    of dprsion,

    !|d

    fEqMcy ofhedach6".
    How.vd, oda studis sngadt

    dcFr*ior! (Ch.@d4
    swden

    and

    M@l!,

    Solc e|d
    1983),

    da

    Bdic!,

    w.rl

    reldtioBhip

    |979i C@t

    !twa

    ed Mol b.od,

    ald ih.t prtiol wirb

    n!di6 fnd th!r"d.!Bd

    Criss

    Ktunlirsq,

    p@eat badach* s

    d.plsiotr .flid.d with wob@ b@ ih& Da, .!d old6 p.ti6lis

    WilkiB, C@t,

    1986r

    Ledds, (1990) egg6l3 th{ 'h.!deh p.lidrg ofto

    exFioe olmjlant d.p6si@

    S.Dc

    paiD and

    pain

    & Muhl-B&n, 1986).

    p.tidt

    rpon Dorc

    nr* ses

    ro

    b.

    ']@

    s@

    Oe yoDea

    p.in" (K6f.,

    din-l r.hionsbip

    betwa th ddclopnar ot p.in dd d@rBsion, (Iischbain od David, 1996).

    Whdly, Mllbw, Ostlsy & David (2003) e8acs.d thd

    wlnabililiB uderlie th dc?Bire dilthetu ed


    for g6e

    dpcaio4

    tbal sa!

    sE6s

    ofpisd. ofd.prsiotr

    in

    'mplq

    .r?er b

    p6o$

    be

    wirh

    go.{ic

    e d@diution
    thd.

    Howwq otha studi!

    paii. (Chlpbar Sol. & Bonic!, l9?9t

    ssdson & M@t!,

    48lPa4

    witi6, Cdl

    & Mol baot4 ! 986;

    dmsf.tc

    ths'r

    (1990)

    didy is .l6.ly

    .ssi.t

    afi..tiv. si.r. @.t s!@gly

    chrcnic pain uually allevialer

    'T.ali!g
    (Bn ll.y,

    1963;

    lhc

    of pain

    Ed6

    p6in

    rport

    1979). Bond (1978)


    d

    odc

    .nd or hasuB

    bed

    sdes, Ptus &

    non hldachc

    of^nidy

    msle tmion

    p@!

    of

    mn

    uMt

    rclation

    doge a 0t

    Adidilg

    wils,

    (t

    1976).

    p.jr ooF bahblC

    moE

    1989)

    on

    cldirl

    dirposilior\

    bll

    d@B,on1

    sSgsred dr,t

    Mi,rio.

    "srB

    with Fpon

    92) .@ofl Od'nad&nc

    of

    $ftc6 hd

    @nrol! o! bsFlin .l61ro-nyosms (EMG) l.v.ls

    & TyF A." This Fovid6 supFn to rbc

    md h.!dach. of eithd rh lruion m

    Rdacb hs $gg6td rhlr li@ ma, b. nmtu


    a

    d@rcsjon

    pln fd

    tht ih. "oEiitutionally d.pcad

    depr*8ior rnd pqM3lity t aits land to h!rc . rtDrg

    rclrc tha

    (l9l) ed

    chedc p.ir' (Stdnhc\ 197q,

    CeL, Nm.y, E\@!, Rtun & Fur,Ldrin

    highd

    3trd

    ovd m xtad.d pdiod of iin6 al$ bnng

    Using EMG

    KE lingd,

    linLd lo p!i!. 'who pon

    d.pBsior". (Stmbach & Timdds,

    dpr6io! ofta

    ed W&d,

    d wilb

    ptui ldds lo fel pair mE sc:lr, tha

    qFi6e

    and

    rcFn a ri8! oryruoe ofhedacbc,

    n@ins th. pait@ of r6poBe to plin cbds6,

    or

    belwd depGsiot

    SDii\ M!,rs,v/onF.h& An iw

    Bldchdd Appl.br@ ed R*dniE

    we.t5

    relstionship

    1933).

    12,2. ,1snar

    Shrdi6

    ta}

    hav slggsLd

    eodd om.dim

    nrgBu..

    6t.

    thal nay

    @ur

    bctrva plin ed de?csion biologi.d" W.rd, Blom, Fawc.it &

    F.icdcl0983)'b.b!vio.al"Fordy@0976)"oorionrl"Enete&Madirb(1986)od
    "@gnitive"

    LfoG

    for

    l98l ).

    s|mb&h ( l9?0) rgoncd dEt "lvlMPI profilB ofttolc

    eralq F dDlog,c.l dish$re Ih& ths.

    difdoc
    th?

    on

    of lh.

    &preion psyc.h!$laia (!t) dd

    ad.ptd v6ion ofCrcM sd Cn

    fstl.

    t6t

    psycbop.lhic ddirt (!0 scal6". Usins

    Erpdiotial indq TePir, ed N!ju,

    !E

    is

    Dc!ruio4 Hlstdiq Somtic sd Obwio. sd6

    tor

    .nd

    parials, indiding

    pstials wilh signjfiot

    rcFn d sigifcs eldado6 oo.ll d! slb sdcE l[al

    djdy

    paiD

    md

    (2006)

    noldra Adicy.

    on thc

    lrc! flqling

    shatiq Apphdir ,{.

    Kow.i ad Prirhqrd (1990) ee86:r

    thlt

    sbj@ts with

    bsd!c!6

    show.d

    signin@dy highd shynd, ldsitivity, psychomalic probld3, ed bhavionl


    dislurb@e &d signif @0y lowa

    S$di6 @ 'AtiCnie

    p6d|il qpelalim lhb 6llols".

    mlbidny @nfm.d

    eiatjon

    its

    Fychiatrid psycnoptnob8i.rl @!dltio!s, I}rb N@iltior


    Dajor d@csiotr
    morbidny ba

    reponed wilh

    indiold a gut r norlidiry

    tine pgccptid h6

    no1

    in Mignin

    Ntrffi

    pointira lo deF6sion,

    Studi6 suggct

    wirh

    ri8!i6qt

    u4

    tholgh

    bm syshaijcally inveire

    Afrgmsod & Mirsilo$al (2005) shdv.d

    nehbjm,

    ! drn

    stonsBt for

    in6d

    thd witlouf'. (R.dad &

    t'. influo

    ofMignin on

    .d. Sildy @nducred by


    d

    s!..ding

    6 e inponei

    rcldionship

    daily hadach., Studj6 show $al childrd

    prGing

    to be

    p}obia bu

    b..oa

    up

    el4orioa

    llffding nm

    ofdcn

    vuiable

    measine, hrpoclbndric s.d hysleri., Petrhi.iric pdnobg],

    hjebo @gritivc

    div@

    Nb$de alw ud 6iain dierd6. Lndturc als

    Mi86ii. d$ eferl th. rin pe@flior!

    ke@ing

    .pp.4

    ed di.{y di$dq, Fni@lldy pdi. nd

    ba

    wilh

    is

    irro.l rim

    i! tinc popti@, '

    d
    ale

    MMPI 3cm

    s6

    in clronic

    Migrain wirhoui

    tiD., 8d lowd halitunion of @nic.i r6poM.

    sM

    h6v a

    12.3. Poin 6,1 Mehory. fte qmhtio bt!@ heldacb. md ndory

    docm6re4 .ldbusD o \Djo.bod.l of psyclologil p!!s of Dcin pl'6

    ssdy

    6ral intortde on the nnory


    M.jodty

    .Fil.blc
    ar

    ps1d.nts 0sotbal & Evrhdt,l9?9).

    willid

    (2000),

    Pwce

    Many &

    daB inrasity, is !

    Ddci*

    in

    E ponF

    ro

    "cf61 ot p.i!

    nosil tu

    sine uplcasl ctlid suld pmt.


    impd. thc reEieval of

    1990), th

    fiDdion ofth.

    @dl lhen

    pain

    erually oa'(Gntr-Radfoid, Elic}, &

    'mdori6 ofrai, .le @n.

    (199{) jnv6iisrld th.

    Rlcbbd & Lopatb

    ndon6 dd

    .m.y ed

    rdll du p.riors wi$ hi8\ Iow la.ls of ffir

    Ac@dins to

    ''In

    (E6ru.,

    for p.sl

    ab.vinsno'.0N)i 6&rhe i

    autobioer.phjcal

    wiih 6t lllning ih.

    in clinicd BrouF,"

    i!dic.t6 ihlt "rndory

    @idr@

    rh. 1im of

    plsr potu

    of

    of@lrld e 6tm.d

    dilbnity ofpai4 ndory.

    plin

    is

    on thc

    blck

    10

    hun'.

    E I of

    words rhy pndidd".

    O. r.rteval of

    pl..sr n.lM6

    @rl.!s( t@ml

    Tht ws $ppon

    by w.ight

    & Morlcy ( 195).

    11,/, Ptbt

    OrherDlsoflLe Sildi.s or htlanaaboli. disordh,

    prMlilg a hada.l'c *ith ui.iy ad d.prsion


    3!9961 thst h}?ft m.r.bolic
    of cbredc c.lhaldgi. eith

    1J.5. P.ln

    fhili.s,

    but the

    of

    or

    (M.lzcl A Dtuis,

    should be @nsida.d in thc

    n-l'-iq

    of

    id6il&e

    sbow ihat

    au

    9l)

    ditrffitial

    diagnosh

    is

    tul

    tM

    MigBin tnds !o

    in

    Comn@ njgnirer i...

    *ithoul au'a (Mo), h a .ewlogical di$.d6 touching ibo* I o./.

    llc C-'"'.im popul.rion. In MA, nienin. hadlch. n prc.d.d

    ad/or dyspbaic

    dicry .fl| d.pBi@"-

    .rd trhdit.lce. Reschs

    prdi*

    niBhine wi$ (MA)

    dilordd

    by

    symptme whch @

    $9g61d r'tnulri f.dorid mod of

    rcvcible Twin fmily

    i.tdit'M

    for

    by

    t$.1,

    stu(ljs

    turic

    h!v.

    q)mor higBin , ad ! sr.rgs

    thft

    sacric @m!o.@t fd MA rbd fd Mo. Si@

    .u.

    id@iiry c{)lmon nig6in..

    is

    d godic Dct61o

    m biologiol

    synptms prcvid. a dislincliv. ch@der

    to

    idddry

    thoe suFcrd of sufrdirs tom njsni!''. Paivi (2009)-

    RdaEh6 ilDw
    orcvid.d

    wft

    4id6e

    tbal cluJlq

    suegesting a

    fiDdinls sleCplbna

    g6.ric iirr

    adho6 h.E sp@iard lhrl"

    dprsi@

    tyric.ily, bll
    y.r

    lrtnoM, qrisic
    sfudy by

    gotic

    hddch. tuv t .

    bsi!

    for

    b.t*d

    nignine dd clstd hed.chc! Th.

    bignift dd cluna

    h@d.ch. @y b rh

    inrici. in0u64' "Le

    Rlsll,

    tslius, Oeas,lrd &

    t@io!-t'rE hadache ha dulriflcrond

    djeqla, sndv

    .lu.td hQd.ch. Equallv onp.lling

    ot th. latra may inrclrc !

    or

    tffiined

    sde di$ila,

    mE mPl.x PIoc4 Ilquinng

    & D6vid ( 1994).

    ol6a

    i sit'G.

    (! 997)

    idic2rs tbll chDric

    "n!@ 5ms

    clrel.tid

    b. r

    to

    betw6 nore ev@ symptm ofhedach. sd fnilid lgercgation," (E ite,

    rhu|M, Ardqsl, Nein


    cn@tdtrie

    & O!6e!. 2004). Sndi6 v@

    of padolr pirh 3Gt@

    @mpe thffi dar!

    ro thc popuhtior

    clhicd chnddistie

    offlsili.l

    qi.d

    lo

    d.sdib.

    fmili.l, roFHdipl.gic nignine (NHMA) ud

    bdcd Ddish sludi$, Ii wa rcported ihai

    NSMA d8d6@0y

    ro

    'tdere

    difisd tm nignin 66dy'ih.

    wtior wa hisld. dd Nn slrDrds wd hoE


    s6." ed it {s s6 ihat ilE offie of nigraine without am w6 higb6 ii
    age

    of on 3.t

    e6 loed, $c .9. !t

    fanilisl NHi\rA. This study hs

    *iadnc

    Disvdy of. loc wlncl

    is

    and

    lirl.d

    clinidl i6plic1ios.
    to migniE hdldity @y otr .

    tovatd morc fr@tile batrndt. In 2003,

    lcidlill3 disovd.d

    hdd chmosde I dlr wa

    io

    in a

    'ssialed

    e@

    liDlcd wirh nignine

    plia

    it

    mignind ii sl'iy of six gd@tims

    b@ldoM oflh pMp th.r shiiix sdim od pot8siu tuou$

    eulst gne wa

    3Eid

    gde, ATll A2,

    niedincpde f.nily. Th. sciadns bcli.rd a mur.tior ofd. a@

    of lh.

    th

    tudoD

    the

    of

    c.ls

    ell'.

    ThG

    'a

    pr6d

    tinsliq brn, &d Oe

    F@ptio. of flshirs liSlts


    b

    dcfnit ly li.kcd

    10

    (lcicbopsia)

    ofhigdin , it q ldd

    $le

    ti.

    socialcd with disdin. au!' if


    !o tnr

    this

    sde

    dd.loPmol ofmoE

    dird ed efEsciou Ecanndt


    L2n. Ea!treh. .ml Phtsiologt H.!d&he hs

    phvsiolo8ical

    @la1s

    "Osmophott! dd la.G abn@alili4 N@ dqnorotra&d ro b. vdv lpeific in

    iMiti'(Kdna!

    dil8n6irg nigrairc bul v.ry

    R*dc! $8sl

    2004)

    lh.t pdntul sliDuhion ofth. rmplc in Oplokinaic nioDlaiiot

    Ei8g6 nieFin lik .itac,h, Studld indidi. thtt" dotid sjc&n s 6td hed pain

    in.lle

    migmsu

    sN.Ptibili1y to

    i! misnie suffdd dd

    .t!tu*s

    strprom ofnisrtinc build uFn ech olhd

    ii . vicic

    tegt nullipl sFplotu thd t(e individud

    nisnine, studjd !y Drumed & Gn$ion (2005).


    tley r!$ sugg6t tbd"

    'ss6ptim
    .6isl v.seld ht?d e.1ivity,
    had

    pain

    nid

    circlc" U.rfoE n is

    lyhflo$

    for

    GMio.

    $ that.\ihft

    infoms

    ilfomdioa pltGsing
    childhood. ,n adDll

    in

    $ppon

    is

    ro

    tbov

    ind@d

    anacks

    qr6
    and

    $!1

    ofmigEin.."

    aidaa fd a distulu mtulior of

    digti*te.w

    nilrscm diffeml

    $.

    vith nigniE F.dispcitid,

    inrasiry gdm intsrin.l dhturbd6 duing

    Ulg.te

    inpotui

    pddting dla.k oI

    s.lptibility ioDug ..d st4s

    e Miat

    lblt

    suggBt

    of

    @L.d &

    ddl

    nsbitution it prcp..d

    rclllcd 3tudi6 in

    Ptincipel

    ini6ic$l

    abnomality & w6 foud intd alia for visud ook.d poldtials (VEPS)" Roe[(d.

    P.@1, Rdcil &

    w.isw,

    (2005).

    Itdodialysis nat indue hadsch6

    s ! twlt

    of

    cl6ltol}ns sbjfts, Tt. rclationdnip h.tw@ bdltologi@l


    scldoD

    motd

    upon

    wil\

    'llaieh6

    hdvc

    driMc si.rl'*". Ar

    ro 0F

    regard to elevaled

    pam.td

    of

    wra od

    & n ,&che is

    h@oSlobin ld.ls.

    relond in @ndnioB such

    rclrtimsbip

    x6ivc momt

    s Polyctil@i.

    b.iwm hd&be & ircn,

    & chronic

    5iudi6 r+on.d a

    bjgb prevalde ofhadache in wom6 with ha.dilary

    ld.ls ofioi

    in the

    th@sbt to bc quscd by byporn &clodd

    bm obwld
    visosity

    in

    @6ia ard

    incsscd blood

    or

    bo

    Fi.quduct l gry banq i. 0E hdin sld hlE

    patiars wirh tuignine & chrcni. dljly badache, ln

    ud

    hd.ad

    htdochDmaiosl

    noulah liclns

    i.

    found

    heldlche is

    hdoglobh vdE. Eadeb6 hlvc al$

    fail@ 'nr.

    '!s.

    hay b

    doE incesed

    blood

    pq@"

    (A@o<i, B.rcl', Sa! Hagd, $ona & Zwlrr,

    MchtdiD

    l*k

    2004).

    dclle in 3tu

    &d studi6

    have

    nis@6!s p!Ii6l3 hs

    in

    tdeniiovaold n.WN

    imporrd i!

    ofmigEi.e (Boait, 2005). It b belid.d th.t

    ?i.cs

    in

    nigm6u6"

    which night

    asciatd siu paia M&y studi6 nsve qmiD.d rh. N.iation of


    OPRMI

    ro

    dpaiDot

    sdirivityj th. Bdt iidi.,r6 our

    l pain

    ..a

    e$cialed wilh lignd press@ pai. $Bhold dd thrt OPRMI nly


    8@.". sludi6 ale loinrs our
    mo$le input Day b.

    6.i "lorg rah

    i9FoFi.l.

    modek to

    (Mcrowstd, ?al6[ & Euic!, 2006).

    @njd adivltion duing

    r,2,1,

    sle@

    e.te

    to ihc

    sarespinal (csF) lv.ls ha


    cxo|alory

    n.mtlleittd

    AlI
    @
    b

    .ll.l. jr

    8 GSNP

    6tlel

    of

    . plin rcl@1

    nct

    intBrigrt t6io. gT. p.lhopht3iolosy'

    stdi6 sis

    indiqra thd

    rh4

    is r

    delle

    in

    ClDmrpalhophysiologica.l@n pbdfird

    probably on dr. b6is of hd.di&ry ion

    b.

    pcediog mi8Ein. anicks, (cuid.ni, Btui, R6 &

    Vwhr/N.amral

    cli.j.l d.ta finr

    potodarion oftd. JOR by exioN

    .Mgnin s ! prD&y nclM.l hyFlgsirivjry


    stindi

    r.porrd

    ddonstFi.d thr't "lowa irtmcirl eieflion bvcls bay onEibute to

    df.dire ESulalio@ of
    the

    bq

    nieBilc

    b6

    in th.

    to

    diffoqr ilr.irsic &d drrirsic

    chmel dy!tunclions. prc clinic.l md

    p6rhophysiolo&/, atrdrd

    rcport d

    jD

    pt!s,, pt.t

    tcrs

    e.t

    Disdin. pandt!. cluraDarc is i Dajo,

    @Fd ncfu6 slsld widdy

    in@lved in

    disnift

    nhuin, Slutu.|!
    acdlltioi

    and

    is

    inpliled in @rric{l sPqrdirg de?r6sio4 TrigBmircve.uld

    {mlnl ssitiurioi

    hB b@ impliqLd in

    padopbysioloF/- It is ale irwlvd

    chMj. 6ignire

    i! 6bMyalSi!, (PaE, Zud.@.A Sl)G, al(W,

    Solos & F!ul!a!d, 2004),

    Litan@ inf(mrs

    r.eB

    .xpldn

    wo'hhg

    6t

    ilf!

    us Osl

    .ldiridi@

    cfuid hyp@siriviry

    p.14 dung

    bt

    It ha

    enich i.

    6u8li!g boding ovd dd

    l dd nol priphBal riSmird ncetu

    hyDqslititty.

    of pdjpnn j &

    hypotbqizd

    rllr

    Ilc

    ttF

    nighjnd

    tb. throbbirg ed

    6q6l

    &livation ould bc . tujor diologi.rl c@poMi

    h.!d&hc in

    obglcd ir

    Glorribl.

    is

    @tnt trisdovs.dd

    for th

    !tuftn

    .hl

    nay

    ds

    it l@tion
    'lvolvdbt

    hyporhdis of

    nighin ha

    nigiedB ris6 ton


    rnagd

    in th.

    slbpdhdieAdmo Mcdunay

    i, ih. dd.loFn@r

    @e

    ba

    by?atre.d

    of

    cbmic

    mtnarbdy $.r

    D6ir8.d

    blood v6s.ts,

    symparhelic

    sitjvity,

    ibc

    d rhc

    lwlts indiqr.

    pain lbr6lblds and th.t oPRML

    narlcd inlasity

    d.ledde

    M
    ihis

    vhich is

    rclral

    !d n@edc

    ed lettir8 rhDbbins p.iD, Tbe


    r,he

    nnilgi6 al$

    qusca

    2OO4).

    ..silriotr ofal8
    rhal a

    dd

    tadin8 io v.!.dil,rioq

    srslo llppling

    dihd@ ard prin" (Silbasr.i!,

    Shdi6 h.vc .r@in


    prin

    @ni@l lprading dprsio!,

    w4ld rd. .trdaq

    ofilc pm

    i.da.d ve

    csNP oropRML to

    @ .lelc t ssc'|t.d wjil

    qpdihoot

    hieho

    pr.su.

    Dly b. a p.in Ei.nd saq Had!.h. p.lidrs 3how

    of@nicd rldiiory

    tut.d

    poradals duing dd orcidc rh.

    bouf (Jafr6l, En&y. Bozik & Jelmicri4 l99O) ..noipdv lv.ls {e r.duc.d in
    Eignin si|ltout

    of

    A, individuals (Knnil dd Mduclq 1984/.

    !!mlf
    by

    tioo

    lh.

    dti! @id

    iDvolvs vaclnu &d tr@nal @npon@r Ii is sugadrcd ilut ihe nisual

    .xpai6c.d

    wirh

    !w"

    (Bositq 2005).

    &teyl,

    Td6

    Hanios, Boaikl &

    ncmFptjdc along with its

    catob e prddt

    @lts $eg6r rbt miepdon 6.y b. ilwlv.d

    Studi6 ilEw rhat

    !oD6

    b pdntul stimul,, ! diffffit

    scdvi9' Rolnilq

    vGculd

    dlmdtat.d iltrl a lorcl oiod

    (2005)

    in

    psin Fcption hight

    schncida, Sisgu

    r@ror&

    Tl'.e

    nc@va.da hdad6 sch

    in

    n@ dlnbit

    cnd

    itigoiral ovsule

    rligbtly

    a@ul

    Ko\

    dfrsdr vedd @ctivity

    for ecndq

    ditfdc

    in

    sabin.l. S.ilmirs & No6r! 2001).

    stldi6 $geest rbri lit6ryl. hlbit3 phy a .ie!i66r oL c Etnirc Feipit


    oth6 Nsgd

    nffiin8

    bei*d

    sbtistic{Dy rigrin@l relrtiotuhip

    ht?..hon&id sd hys6ia

    r3.a, Poi, adt

    and

    Fodit,6.

    $.

    ddad@s on MM?l

    sqft

    Epon of ahbnic pdin.

    "A Lning ep of

    @d.

    of

    rMgi ..d

    n .d fo.

    vdg@@ ed relruing lsciaicd n.gaiivc fe.li.8! ruch 6 binmds md l!@lrnaf'


    (Di Bl6io, 192)

    'Folaiv.,6
    ofod6.

    Nol by

    .!dawin!
    to

    $d".

    lo

    vi*

    (1990)

    lhar h.

    viws for8iv66r a rhdrpulic raor


    of

    of @gnilile rcsiructuring

    tEl

    lh. @gdtivc

    sh.

    bEl 16 t$! olt6mtiv6


    acl

    forgi6*.

    ne

    mpldals

    in

    by

    bs !b@d.

    llle nghr

    ro bc

    to

    psyclDthdtt ed

    ud6rr!& forgi@6

    the

    notiv.

    se "fdgivoss a a volurr.y pr6s

    od Dultiple acL of the wil

    volulary

    baddoa

    tb. offaldd wirb

    walt B (I984)

    b6

    doyirg ouslv6 th.nghtio su.h.0.c1 ed jldgEqt

    dimio.

    6sidm

    @uaae

    ovd.ming ofth. n.g.tire ffet ed judgbdl rowaidr th.

    subkovialq Ediehr a al. 0992).

    Csd

    onldl

    is th

    onplerC'. In Wlhd'r

    abour how on.

    &rt

    $c

    spct of d..liog with

    thar

    vid

    lelly r.quie
    *1h.

    p6on rho h6

    d6roy.d bt r6etn6t'rbicb ldrls

    sd 3 d*ision ed clDie

    in

    to

    dath

    rd t

    with dre psr. Hot (198r).

    Clinjcrl srudiB suggesl th.t h.{dsch patials havc diffcdty ftrgiviDg pglonq
    tbey

    p.@iv. $ bving offadd

    relalichjp

    t twq fo4ivas

    with chrcaic p!i4

    Ftiats rbo

    lnd ir $n.

    My, studiB $gg<r

    1h.1

    lh@ k

    .!d pda .rga utd Fy.tologisl ditrle! b Plriots

    Eporr rh.t ih.y

    EaUe lo fdgiv

    0$6 nidt b.

    exFf,4cing DoE psin 6d psyctroloaical, lb.i @ ncdiaild by highs lv.l of stale

    ''In d.fininS

    offdgiva8

    fdsiq6nnc Fy.bologic.l liidtw

    for thc

    fde)vd dd

    tbc relc

    offorgiw

    tD.*" Roq ll.lling, Davisr l:ifa, lovd


    Hadach. i!

    ftr n.b lhal

    squ.lt

    10

    ictds lo

    itr

    f@!

    rot @ping. Ih FreviilinS mod.l ro


    ond

    impuls. An .lid.liv! viqvpoi.l

    c@ut

    .typicd feial p&a b

    is

    for all foms of chtonjc

    bd ltued a ih.

    D6ir &r t

    dird nnf,isio. of

    th.t 'vd.d Fychologjcl frctos Pl.y & ihpondt

    mle in the gcn6k, da@oation dd naint

    ree

    of

    rffit

    pai!

    mdi$o!!

    propd dplicltion ofths faclos m aid in bdestntding md ultinately

    ed Tak

    lut a

    Flor (1984) haE ad@c.d t bio psych(Mial

    low b.ch pai!

    TI'e

    or psycholoSiml

    FacloB

    lil.

    of Ihis nodl is

    6dts non lh. inldciid ofdi'1malll ddb

    It

    sod.l si.i6

    Pilb a
    ib31 th

    Ia.loB onpnsing fic disth.sis may vary for och individul.

    phttsiol build

    specific physi..l

    rotn@t".

    nod.l of cnMi. !ai4

    6tr.l Mptjon

    predisposing or8a c or Fycholosiet @nditioo o. disth6is.

    orgdic

    .nd a

    (2005).

    vhic! rh.y h!v. h!.1.d ! dialh6is -stB mod.l.

    lhar'thdic

    td belirS

    ih. thd.patic

    & Ve Bro.l hmt ( 1989).

    '$im.dicil oodel, dd ir it cbdrc1dizd B vi#ing

    Flor

    bo.fis

    O.

    pain eilhq phlsicrl or psycholoSrc.l, H!d.ch. is a cry

    psi4 ircludirg hdd.cbq 6ial,

    ArdaiL

    on

    hali!

    natus tnd Fychologidl @nditioninS hislory

    Th.

    G@ll for dmpL inju, intd.t with a pEdisTcing di.th6is,

    Guldng in . @Dplcinl

    of pain. Thc

    {)<:{xlfu* of @tioBl od plrsicd f.c1oB wilh

    which lhc

    indilidlll cdot

    idsion. The

    spM

    inclle

    in

    in rh. involved

    bnditjr@ sbsroc

    12.9. P.ia

    Eirftd.d &d

    cope adequ.atly

    nuculr

    ft!.

    tosjon

    lory ldsting

    ftlr *iU

    6e

    @.1 S@i&l

    C6t

    h ihouslti io

    cd l4d

    ilchdh

    tb. ptir

    10

    d incfu

    in

    tusld

    ischnit5 which Euss a r.flx

    rcl6e ofpait eliciting

    l@ds lo s

    qpdiae

    if the

    @.6tition

    Chndc p&n padar! bd'avid ml

    rl$

    sha!d by othqs, tDt

    to

    l..i

    int66

    is

    6ly

    .ttd sh,.pd rh. be.hnior

    is

    ofdh6,

    't

    t@hing th. spow lo lronpt &d

    stralior

    c!)mr

    10

    pain, Social @ntexi tlays s

    study alm

    "@ dtual

    willi@

    rci or.d.ptiv!'\l.ll &tuviol'while bidhizing

    and

    smind

    rhe

    dviromdid

    si9ifi6l bl.

    frdts of

    facloa

    in th

    eci.l @.ldl o.

    of pain

    tle

    in and stated lhat

    imponet in lh. pscptior of elt Pain".

    & David (2m3).

    l.2.l0.

    qp.liliti6

    ro

    Poin

    a.l S.f Efr@.t,

    ddte! eim ld.lt

    (B.rdu,!, lary, Tayld,

    G llid

    of

    " Sclf

    .6.*f

    Flonde

    d p.otlet judsml

    ard to

    also showed

    ddis

    of

    th.n

    @nsol ovq

    dot3',

    toloae

    fm pdn

    & CGsrd, | 98?).

    "lrdividuals s@ring hieh on s.lf .ffi@y m.aslro

    od

    4Paime

    Ld .

    hieh

    didace ofin@a*d ddogmous opioid adivalion wna onAo

    wiln pai.tul slimuli. On. mod.l lnat

    li.I! dpr.rcy

    with tu ction

    cd

    c@6 fon @lf

    .frqcy lnory", B&d@ !r al. (1987).


    'Applidtios ofself.trc!.y th6ry
    .xclsivcly

    on

    tdialt jdsnan

    to

    D.i!

    pDbld

    h.ve fo@sd

    aboul lbcir ability ro @F with

    (Coucil, l98q Doke Cr@k6, Mol.nciG & Dolcy!.

    .lte.l

    d -"""4c p!in".

    1986).

    Ths. beli.fs m idqtifcd 6 plin *lf.fi@cf dp@tatiom. studja slDw ihai

    't.h ell emcicy

    judenar.

    6n ltt*

    posilivcly wilh borh pain tol@e tnd pain

    @nt ol", (Dole a al. 1986; MmioS & wDght, 1983).

    Racto& & Bich{d 09E8), found thd "diery ald pdr Ftiars rad lo ova
    pr.djcr th. inldsity of fi

    *id lmilg
    td

    hm", Thft

    is

    dothd dplealion wnich cm4 nom tne

    thory- Bedun (1978) lain

    nie)lt hav. slr6g

    lit. o&a.vdiw sl!r6lilc didy.nd

    irfoftnioml rdE rcSardi4 oB

    Gffica.y

    judsndt orqdurirg

    physi.d laslq which in nm innudG bodvation to perfom task".


    'Sclf tr@.y dpcdDci6 afd

    .fr4r

    p6odl

    goak. P@tral gorls io

    influ@ s.lf.trec, qD..teci6


    @n6dace",

    irdiBdy
    buffa

    bele

    of

    go.1sigDa

    Pain

    r.lsel siri

    $ppon

    dq*iE

    !6ms

    l9?7),

    *!s dir.dly rd.lcd

    rcldtd to derressioq hiSI ldels ofpain

    (be Glation

    iDpucidy

    pmbld slviig @np!@ ir r.lahd

    appFised

    $tuuC} iG

    tM indpodotly dermin p.rfmde dd

    (Lelc & ktha l90i & saleiclq

    "Lo{d *lf

    d.pBiu.

    Fdl)|]rDe di6{y !d irditcdy

    rldsi

    to

    plr

    10

    in@.d !air,

    .!d disbility hut

    $cial $ppot

    we

    fomd

    10

    biwa Foc $lf rppn!.d pDbld &lvi4 mp<ra@ .!d

    synploh.", (Robdi.

    Kdn Rosbde.

    & r.h!,2002).

    l,2.ll, Fun.ndalS.fEltra.r, Fu.tionrl slf .trqcy spdeci6 (lSE)

    s q6dre judsM!

    .dared

    to

    &d

    d iDponhl

    rhy

    cery on t.'lb of ph'sicrl

    Frij<L (1988) $8961 thal

    lbe

    pdfonfue, b@ue

    &

    @B.q6tly
    iijlry

    in

    l6s litely

    ani.d

    psfomd@

    suseFible to

    ro

    tbey inv6t m@

    tlcy

    d.b

    hiS}q

    dFrd

    le

    be

    .ffon .rd

    rhadat bam dpstatiom",

    ld.l

    .trdr .rd Fsist64 tud

    b@bc pr@@d.d with dp.d!li6 of ntthd

    parioG wirh low FsB cs

    bqN.

    pdfollme

    havira higha lwel of FSE

    beliwing th.y ould pdfom frnctionrl Lsk @uld b. .xF]rd lo

    of physicl

    rc

    ro

    il notivding hu@ b.havid.

    Hsillon, Bo*a ud

    rd

    ln. rbility

    xpded

    !o

    pain ald

    &hide lopd lvel of

    pdistee i, iadioEl tak ed

    cld Flslion$ip b.rw

    Th. bli.f!
    @pabiliti6

    rriD rcbl.d bchavio. & bcli.fs

    of clmnjc pdn padats alour th.

    [a td shoM."

    ndre o{pain .nd abod lheir

    pEdiciive of@9ing efons dd thcir .m@y", (Hdlrlpa,

    on

    ,6on,

    l.2.lr. P.i, and Coping SOIe Stldid hve als xdincd lh. asocialiot of

    vei.lili9

    of@ping siyl. and

    Ltnat @nplilre

    R6ulrs itrdir.d rhd rbe

    tralrs

    gst.

    tm pooE @lon"1,2.11,

    respoB

    to

    Ptin ud

    .Ld.e

    "eoidde

    (IrI&n,

    Slrlc,

    higb o!

    & And|w, 2002)-

    Copin&

    @iry following dE

    in pain

    Sui D.nmbilit!.

    wltle dircl @pin8

    Th*

    coping

    i,
    e

    sd 8ssi.i.d

    findi.g3 @ oBistan wi|h lhe

    rele in sudaining cluotric pain",

    h is

    thll $bjel giva pos'tiv.

    infomarion, s@.1 dBiDbil y, Fedictd si8nifi@r

    ddd. dEq u

    An .lreFatiE hlTorh6is

    h}lofisb

    foud thlt.void@

    1983)-

    th

    $ci.l d6iEbiliry lcoc tedcd

    ro

    .Mq

    . signifiMt

    ro rcpon

    lropos

    thc

    ldg

    pdn; th6 rh.y

    mout of

    in.aay ed distd.ti@ tri.ls. Sn!j-1s

    xp6idc.d, in ords to win lh. appoval ol

    $!j.ds

    It wd

    occsing duirS lrrd!.he d$d6 wa 6echl.d wiih

    TrW & B6d.y,

    .otr.l dp4r.rcy

    wiee

    Fd&.Lz EptM, Cliffdd

    behavior bay piay

    Pth il

    outd., whq4 ib9lictior of


    (mtli6@ dd in

    d with

    in sbsqMt h..dehe acrivity.

    view lhat

    1,2.14,

    *gEtir dmtbN ws assi.l.d wiih

    p<)lE Eatndt

    6siat

    b.

    lwA6e

    doh

    sirssin

    10

    (Ciphd, Dlisba

    inlltNilhadrhci
    rnh

    of

    @npli&4, dd !lta trelDal

    dotjoE w3 foad

    negativc

    "$qor*ion

    in pain and hadache PaliaE.

    who

    !@

    ldudly

    .xFrindter,

    ihat I

    r..d fd $cisl

    .ppDval motivals

    bde

    hisNy

    prcdiots

    sisniicul mlaiioD b.twa $cial dsiEbility ad rcduclio. of

    inhlv.d

    in

    dryinS oul ilen $ggBld pld; ln. l.l&r

    r.2.r5.

    P.h qd EthrL Din mee

    Tt@

    &

    pair ditrqudy-

    t\e

    aduic

    siE

    difrtue

    in

    cpoi..

    to p.in,

    Dfcdt @hG

    Zbdo*ski's pio@ins wo* or ah!i. ad

    dpsioe ofp.iq nudu

    Bpond ro

    einlii ditraEq i!

    cliai@l studiB irv6ligaring s wjd. vdi.ty

    oditions hav. .orcd annic ditrffi@


    Spci6.dly, invdrigrloB lav.

    in the

    pFvdoe dd *vdity

    lgrty

    indiqr.d 0l.r

    ofpdnftl

    of pain.

    Afri6 Anqids r@n

    g@td ldeb oflFi. th& whil6 tu 3k! @ndnios a elal@n., AjDS, migain.
    bsda.fE,

    ja

    pei4 DonoFlrjve

    pe!o.i, johi

    !d4 D)Dfeiat tliq &giE

    p!i.,

    noi.9eci6c dlily pain! ud arthritis.


    UndcBtandiis of tuch fndings r@iins

    thfi lhysida tad

    '

    to

    Fwite

    ditrot! sa@t

    studis hav sue.srd

    t6s .n te6ic d.<tiqrio! for AAitu Amaic@ rhd

    tnwhit6", RobdR. Edwdd\MA,Dmi.l M,DolctqphD,RogaB.Filtingib,phD


    ed Deiel Lowdy, BA

    (2001).

    This is luppond by a

    (Anicarr

    Afdim v.fu

    nubq ofstud'a

    Whjt) @ pain

    which

    qdin.

    rhc

    tot.1ne, Re$rchft

    cffiqcy of dhsi.ity

    del

    -.thnic

    dfaoB i! Bpo$ ro bodr clinic.t d<t dFibord p.in ,. CMFI CM, Edw&d.
    R& lillirgin RB, 2005. wds pJ, r$fXX, Rowborba DJ. (2@5), craai p,
    Amdt-Niekd L. (Pain

    2005).

    lm

    j! which.

    gEal

    d6l of t*.rch ws done "Clronic pain p.tiats ditrd ir U. dceG io whicl lhcy

    lifl

    r.2.16. Ptia and LMrs of

    thdslvs d

    h.ving

    rol

    (chm@ & Powdtul orh6)

    v.s

    Coriol

    othqqraD.lf.dors, hlvir8 @

    p!$ot! s@rir!

    ofp&ir', CIooDy. Mana Ab.shje & po!.!


    1,2.17,

    P.in

    of oDrrolb vdilbl

    rDl

    oEpsjr,

    hisb on tocu of @!rbl Epon lowa ldels


    I

    99I ).

    ud Fmitt Fsily fldon h.ve l@g b@ ihpliclrcd in 6.

    Eijolos/ of Psy.ho physiotogicd disdd@, Th@

    rwo

    tuu

    for odopting of

    fmily

    thdpy

    apprcacrl A weu

    lvhd mof

    dysfindjon

    .vido

    to sDgg4t th.t

    tcec

    $e

    iucto.ing faEily
    it' bdbqs

    "spow ofcnrcli.

    phrioloeical ed pychiatric di&rd@

    pair

    tlelally

    ol.

    sbon

    P.tiat Th*is

    of . prin

    sffq6

    tib. beme

    dv.lopd . vaidy ofPsttl'o

    th.y @ rcquircd to @P witii che86 in

    intdpcMn l ..lafodhip &d .ddilioal bud6. Ra56 for ilslvinS lb. funy itr

    Eatndt

    of chrcnic p.in ddivd

    ddor$rar.d
    of

    ln rcl play.d by

    clmic p!in",

    fon c6ida&L criniol

    l[ f.mily

    ndb6

    in tn

    'ed.ll

    lld hrc

    Fp.tultion dd trolongalio.

    (Block, 1981),

    i!.

    'Ctlpnic pri! b tb. spow Dy Eli.w 6. pdtia of tuit l Gto6:bility

    pltiaas position of d.Fnd{hcy my b. c@mpd by Ib. edl


    th pair behlvior 10 hB or

    lone sirldiog @nnids,

    rFF6

    or

    lhu Einforcing

    ha oM ad. Il b.y giv ri$ lo udeinbl nllluality by

    moving

    4 ill,B

    3Dou!.,

    trevid

    alliDg a n4 loDosl!3is

    !@@l&is ir ! fobiiy

    Thc noti@

    &d 3

    sy5l@ is w.ll .dlblishcd"

    (Ron 1984).

    Feily nmbd $me tim$


    iholgh he

    sbee

    rcinforc.

    illn.$ blwio! tld ttsl th. paliol

    s@ i!v.l'd sd sDe tin6 t!.y itlc lh.

    of oryuic prdDlos|
    Study by Flor,

    Tuk &

    dc

    rDl hlw

    Rudy, (1989)

    Bpote

    s.m

    l4.h

    th.t th pauat in lh.

    sgg6& 6x "ELrionship olhft eitfNin8


    a

    najor stroned @rcltlion belwm

    &d ..laLd d)56bction",

    s1udi6 by

    rcponiie high

    vi4

    pobla.

    bchsvid rnd palinl psi. i! @mpld, they foud

    cirforcing

    opPosib

    dis

    & vin5

    ( 1990)

    nw. fould

    tbat

    "p.jn potiats who

    ofs@al slpFn adlpl lo Plin m@ efdtivcly

    a.1iE wnn

    bwd

    it k sugg6t

    dat th@ is al$ alotbd diFdionto

    6po.sivd$," *hiclh

    lappitB

    silae

    .nd joy, b.)

    @nsists of, a )

    Endracy

    GpoNvds 4

    snd quel

    ltGtilitv @ shom

    typ6 of sPoud
    (Flor,

    Kd

    Fpons

    to

    to b

    . colM@ Panm of irn@odd mons

    rcinforcirg

    Pain is

    6!oDs dd

    dd @.iving

    c.fiain

    @pLx,

    Elalcd

    jldit

    ! wnol. h6t

    n.i ada

    thv

    in

    ptin lnd dislbilitv

    Fslondd

    'eFr

    erv ro

    hr3l6

    $8sel rhd t'ladoBbip' oth4 eiDlorcing


    foud bajd s:rooga @ddti@

    '

    dtds'rion-

    sddin'

    &olh6 6itic.l tunction oftain

    Pttialt

    '

    The

    p'h

    @out of sEcor' nel.pl$fic

    motior b r.ll 6tablisied,

    to

    rcbtc lo

    who rpouss w@ ovdlv 3ol'citoB bad

    ladott

    ftnilv

    invstigdos have studi4 how difrdml

    nv

    Sbdv bt Flor, TuL & Rrdv (1989)

    ptriol

    fd

    sno* tpo@ igmEd o

    of plh tnd lowd ld'13 of atuviq

    bhavid &tt

    love'

    'xmplified

    dfit.d 4 th. alilitv to r6pond alprcFirov'

    plin b.lnvid

    & TuL, 198'?) potidr't

    Emodonswnich @

    !ik. .nsd dd

    Moni.S' Sddll

    pai4 had high aclivity lryl,

    l*k

    dotim

    Afrdrrre

    1.2.18. P.i^ @.t

    wlfe

    pu thc fetiv'

    u'

    sv6

    dte

    b'twd

    fsdioN olsldng

    of Pain to @nvv

    Nsc of

    orbis'
    ih' pain fot6 tn' spo@ to cde inro thir
    i5 ils

    bdiag

    of!'h6tc ed 6

    N 6 a scrp'goa! pain ce b invoked

    prcvide

    ! povgtul ddonal'

    for rhc

    olpa$ologcd sroFos"'

    EPsri!et

    'l

    (19s2) bnve

    idoti6'd

    six

    tin&

    of involv@ors

    s hclt or

    c Ndislisric inwlvdot &d d'


    involvd@rb inwlvndt dcvod of fetins
    inslvdot & I Sttnhiotic involYd't
    Enparhic involvdat .nd ovd
    '
    lif' sras of t fdilv
    laclos also ned onsi'lmrio6 a lh'

    b'

    The following

    tuturiotr of
    noted th$

    pu i! olii

    "sFplotr

    lt is 6equ6{v
    naEsge od c ihc quBtion ofh'n@tksjs-

    Plav a

    trjo'

    ptn in

    ndid rhriolship

    lhe cpose Mth

    t!'

    $e

    lFptons hN bd dsjbcd $
    in powa

    I!.ting

    p6on

    thc

    widr th powd

    o .[dativ.lv'

    lh

    !'Mn

    ,hq thdforc, uing lh. tvnplom to bring .bo!t ! bal&@ in

    hioircnid in@lstuity" (M'!.!.n6, l98l)


    "Th.

    sF

    iom

    of Psin bav.

    d a'tigrr ofllcl ofintinlcv

    (Kotb, l98O) dd idotified

    It js sulgel.d

    dout

    of

    si!i&c,

    into lhcir orbil!,


    Pain

    th

    b.a assiltcd witl tttt'lsal

    rhe Psin

    sfl6

    the

    it b wel er.b)ish'{t

    !.lonaliz b.hNid 'rd

    l.z.l9. Pdrr

    dStd stts

    is

    upoo

    o68y"

    Gd.l

    i is no

    sid'd du.l

    (2OO?)

    previdc

    of nind

    Pactdd (1998)

    6d
    has

    hodv in

    of the

    plac.d uPon

    point'd out dst

    orsu ed ti$e
    6

    in lhc

    sdgv'

    body,

    eou. lndividual

    bo<tv

    !action lo ti's3

    silis, !traliz.d qp@tttio4

    for thc

    6!

    sp'

    Soar'

    n'ittad@ of

    whd

    dd tm*hsr ncbulos ir

    trv sid

    he

    dd

    ilns

    "s1t65

    dv d.tEd

    in

    d@dd

    Shatrd

    (200)

    't

    ir"

    $' veous

    @mndlslitd dl pdpl

    e $bjeltd lo

    dd th' 6pont to sr6r involc all

    drl

    @usl bgse

    uton

    d@dis nade upon

    !P @m@ lnMd

    16 tbc l'vel of

    st'6s elared

    is to

    djen d are

    qwit

    !o

    chuoing ston&h ti8h slouldds, ldsin6s

    synPloN @ ignoredi

    ndiagc

    b'dv to

    6?08

    defnilios of$r6is lhesont d.rud"

    ddmd bci.g

    in

    lo c@e

    t'qu@llv inplictled dd is ! 6nLib'ni!8 fi'lor

    Pl @in'dy

    Feific rdporsc

    cdi'ir

    snc ti@ fie psb &ttG ta spow

    ro
    in th EiioloCy ofhadache! st 6s is difficoh

    definition. R@ &

    ih' ndilcl rl'tionship"'

    Fle of $eting od taivinS

    soihd inport!fi nbcdon ofp'in

    bc us. to

    in

    beilvioi

    selinA

    Poq

    slch

    l@ his!

    3Fpto6

    suh

    @rdtlijon Mv ocd lfih*

    s hscle

    @ntra'rion hqd!'he dav

    dt inUud'd bv lh paocplioA Pdsonaffv' ag''

    pnor

    cE i $Ppon sv$@ dd
    'xpdiaEls'

    dte

    sp3cttv to

    Packlrd (1992)

    hs

    statcd

    i|lre qays, A.) by inpoling

    6isrde.

    !.$le

    B,) by dir.dty

    Bdivity

    Tne

    in

    "stres @ o.triblte

    lm ws

    dd

    Mig{e

    C)

    1982!

    surrori the

    bdv ed nind t

    nl. o{n.jd lif. .E13

    !t!.ls" Holnr

    ls e@doF

    ducing

    or ch&8ing

    in tbe

    'tiolo$/

    of

    nEquad

    3tr6tul

    dois

    1986).

    l22O.Pti,6d Eratlons It ls ba

    su884Ld tbti

    "@iios v6 itponol

    ofp.io", (Mdskev, l98O) Phvsicids bdv' qplain'd pain a m' ofin'

    .xFidc.

    s hFldicd, (cdvsr I94),

    ''Th*
    hrluci

    ibe

    it

    Blsch&d, Radnitz, Evds & schwdE 0986)

    6ay @ftibur.10 hod&h6

    srbploEs

    o.

    bad.chc ddclopDdl

    d by aggnvlti!8 dd alrqtv didila he&cne"

    Th@ is $nc oide@ to sgg6t ih.t

    in ln

    td

    ro

    FEipiLlirg tutb.d nus.uts dEtciio|\

    is little cvidDd {o

    AndtsL,

    be6d.ch.,

    long

    $d

    ri@ it

    sit

    MF

    nlqua+

    of lltrtrMti!8 61 tb'

    h.Pp@ in

    of

    Frn' Plinn'ves s r

    scliaPhMit dd dghl h'Ppd al$

    in dplsior"

    s@ lv pain hrv di* 3 'nv$6cal @tYd'on sFpt@


    '[!is vE . via giq bv lud {td $pPon'{ bv of hvnaicr! pdi6l5 fould in
    in elicl p6in is bd dtribultd to Eaial prrt* is lhtt
    Dair clini6. Amlha d..isjs

    Mdlcy

    of

    & walM,

    nucl.

    (l9EIi

    re$i@ l4rb to pairr ed thi! nu$lc

    onmction, b.caue ofwhich ft.tabolite aE


    which

    &

    tsio on'

    not

    pep'nv rdovd ion

    thd ldrting b pain Fodd +prclch tia13

    Pain

    @ndjdding. Pai! my tE r.rdcd sl$ to @otioD, P'iDfl


    psycholo8rcal cbAee

    ed dolional

    s*

    ogdd@

    'ko
    adtu 6 ri? dotion.l !lal. n.h.8 it wo6'
    r@l.d th. Pait

    d1a!6.

    ton dcsivc nsculd

    And il is

    a disile

    nh*
    Pain

    nd' odingi

    noD

    oFul

    win Prcdue

    dd ! phvsiql cse

    t'6

    s6 qla dotonal mrs

    's

    Thorie apl.idng hadac,i. vrt tu8ing trDn divirc (@ginrl


    psychosial dd spidtual i$ud b lh. hi@s@pic nittic

    6liq

    As

    dbtustd,

    uehsblu8
    ofpltiots*il!
    to

    ,4k

    Pain

    $ff6!8 s

    ylldi& Enrl. taortd

    $frding,

    @e

    c.s

    ei0t

    Md (js

    pMt

    d sdiosl illn*,

    Enslc

    wilh

    ba

    pMts

    b.lidcd clmric Fin Dtulid.d

    tun ou lgrrBsior

    $. .rioto$, ofp.in

    NDlq

    p6vcholosi.il

    of

    FEi

    &

    1895)

    ce

    st'rdi6

    apps

    PDt" P.tidts who

    Engl (1959).

    cnd.rdiz.d

    h6! cJEsrisal

    displ.rs of cffEtion" in
    lEd sufrad pair

    ipBi@

    6 . gop of'lain

    PatioB chiklh@d rchdo$lip bs

    @lv.d

    di& moldle

    of(B@

    zed sine lh. publidtion

    p.ir 6 6 fom of s.lf putulndt.

    onr

    ! nod. of

    sin)

    and

    h.d

    of adtEs

    bv

    viol6e' aggBiotr rtd

    ebe tiD6 wiih'ovd mp@sijr8

    bd

    @ld md rej@tit&

    ed oft6

    ae.?l!bl. wly fd individub

    lsv.

    i,DPli@t d c,hildhood

    to

    6F

    dvdity i!

    in odulls, (Swdson t .1. l9?8; Cftss, Roy, violin & W.lka el al.

    r980).

    thc

    oitiv.

    bchwior

    dplaDtid th.t !oi! &d dis.tility Fsisi a .

    cul

    of

    reirfoI!@di @nti!g@t o! 6void&e b.hevim dd dplaint b.h.viol'(Fotdyc,

    r9?6;a

    Ia

    Flor d .1. 198?). A

    cld

    rhdonship

    b.tv6

    pah rclat

    b@ shoM; "tI. beliet ofcbrenic Fir prlidrs .boul tb.

    b.havior dd b.liefs

    rt@

    ofpain $d alout

    rbcn

    oh spalilitid re prEdicrive of copirg .forls &d th.ir fEcasy"

    l99r

    J6sn

    er

    al. l99l;

    Th. psndiry

    (Hdlclaa ci al,

    willi@ & Kefe, l99l).

    fidry

    ofh4<hah. posiular.s & asdrl dr,r "individak wirh

    cdr.b Fenality tnic, qho d@urs spaific tinds of@!fli.! wiu dd.lop rpi6c
    b.ldacbe
    on th.

    disds"

    this tl@ry is b6t ir?in.d in the Nqk of Frieda &

    Fycnoga$ir ofdigBine

    R&lnd,

    (193?)

    Migrsift is m exF.ssio! of un@Ncios hostilily alitut @!$iouly beloved

    !Mn\ milrain., pa$ab rm

    Ftu!
    th.

    l[.

    btrcjc.r5

    se

    lnir hodiliy

    b.lovd sld rh. hn d

    liD? buning the iltoj1cd

    0m oltlq pq$tu

    aeaiBt

    thds.lv6 Th.

    F$o e i!.r itrjuinS ib@lv6 ocd

    p@! sd vi@ v4& Migues bq

    desibed

    psf.ctioni$. ngid, ordqly @DpuhiE ob,3sive dotiond, P@upicd vith

    ttgtil] urstjv.
    ChrDic

    ficy htE & iMbility io

    rdio! hed&b. sufl.@ e

    qFd

    usDatly

    al

    $(.4

    i.8!tiv. flin8s |9pmPrilt ly.

    wonimq dp6sd hbt idic, &d

    psychoslrlly cdf licted.


    8@6
    I

    895,

    sus86t

    lGrd in ce bisroti6 cigitr.lly publish.d i! tbci. sludi*

    &
    d

    lbd

    pd

    6uld

    be a

    hrslah in

    lcqud& of a plltholoeicd prcbldr! thd the

    @nEibution ofpsy.hologicrl facton lo prin

    wft

    'wnriddtd

    Fsitat

    bclidir D6y.ti.t!ic circle $rt

    FFud sb.!.d Ib.

    nte

    gsl intluoa of

    p!i! ir ttc ltaog ofo4[tic

    nldings i! du. lo pltrli8rlic ailn@l!.

    wolf

    (19?2)

    rb. tuieEirc patjo|l

    op@lirs wiihin ! th6r.li.al psycho+oDatc pdpdive, po't!y.d

    a) @bitiou {d @r6.d

    dell ofz6teda66|

    . c)

    Sairly i&lrr.d, ed

    wirh

    a.!iw@.rr .rd slllra.

    bive lov

    b)

    g6r

    ofoda ed Eisree io

    cheec, inflexibility inelaticirt. sh6lloMes, @l rnd .loot


    Study @

    rsy.hologiol tun riding in hadehc

    sdfffi

    showcd

    'gMtd

    Fy.Iologisl disrub.M i! badaclE patidrs". F Ar<ldsiL, Blelad, Ard4 Tdar,

    Tde

    & RodiclDt (1982).

    Aldddd

    (|

    950) posrulatq

    F chemrtic diedd
    disposilion

    10

    p6@ality t

    ove

    slo

    a)

    nesdy

    @ndiioN for

    l[. d.lelopndr of

    h irndncd ogu watr6s qlncnbiliry ofphysiologiel

    d io

    aits c) sp@i6c

    thr

    sfds ed to ddelot rymplo@

    in rhar

    foms of @nflicl ciiltd intn p6ychic

    oGe

    b)

    st of

    d irr.rpmn.l.

    T6ion
    mo$d

    th. aotions

    prod@
    our",

    is fie

    dd.rlying

    th.y dotr'l bs& rtroud lo rh. @miou

    ihori6, ed studi*

    .xFide

    of pth

    R@dolpb C-,

    Eplasl
    have

    s@ y@ intdnd ngc

    *dd a pl.ast

    Am!,

    M,S ard

    inFtlln Dl. i. |E1r@r

    snd D.in

    h!.

    10

    Th. br.in

    dc

    not @6e

    Jdi.

    ba dsnld ty

    st ts rugDol th

    tutional sr.r6 diDinish il". Mdy

    Ma8!6,

    W.

    L. Rudy, M,S., (2001).

    "drsgdlted

    hadach. d'd

    Daq AMdcua

    @otioDl sr!16

    lhoh lhat'\rnpleMnt moii@al

    Res@ch6 ale $8g$ thlt

    and

    min<L

    wc

    (2006).

    R.lltituhip btwd

    Tut.,

    maiy back preblm8, H. sble6 'ta'n

    th* lFptms a ! disliA.tid ro D*e

    sl!?hd T)rs

    $dl

    @us of

    pain mod'rblion

    my

    fbmy.lgij'(Fl|{S)- Alilo

    play

    o-, Donis C.

    M.D. (199).

    Copp. l9E0 stai.d "P.in is

    . $bjdivc qpdi@ tmy Fsos

    pain

    a & rll

    po*dtul &d 0'6trs.lve .r th. nwy of inl. rwhcl,niog fire". thcy deibc thc
    pain

    nftild

    idtion.l

    md ov@h.ln'ng they

    r.!d

    thir

    clf{itu.lion 6

    fragile,

    helpl6, dradirl, rbedon.d d $frairy Copiq dBisls of f.i., rilu.l &d mgicd

    lbi.Iin8. Sm. @

    pain

    a stong !h.D, donimting, pi$dic .rd

    onsequde, 1h.y 1hd*lv6 h@mc


    6gh n this dn.). They
    lnms.lvs vith
    pain

    d mou

    n.y h. ! lity,

    sem

    to b a

    cope

    l61iry

    the

    $ldi6,

    liid

    bngbft pain ffrc.tively.

    whicb is put otr

    for

    ey (l u

    individurls

    lif. dad!

    'ft@

    is

    soinS ro

    sislifee

    th. s.el@. or thinkq, rhe

    fd thme indiviluah, p.i!

    ddsdin& hddd nysidiou & c{mic

    schi4

    .Md

    Ihtulgh mu&I. log!a9., delwith p.in by .lignine

    sfreing & oduring their prin qpai6, r.qui6


    mcdilni@ ad

    t61ing

    thcy

    copins tbtulgh

    m@i!& tLdl dpdid@ @trtinG

    lha@lvB

    f@i.8 o.

    lotrg

    lna

    rb. pah hs a

    E
    pain into

    prsi@
    erdg'

    of ihe p6in

    an

    cxpaioe

    lhs

    muic & po.try

    is c@pcllilg & lhe individuds

    individuak ond dw.U on (phy now) $cy

    dddibe pai, d . tumjrg poini in iheir liv6 o @tilue

    Th@ h th. walcla or th.


    vigil,

    p.in

    *liting

    for

    wlit

    they

    out

    b. or

    dDry to

    nay bclp riE pain but jl My clolrd lhen

    $eline

    dy rinc, d4fo.."

    rhay

    @sins of pain eticip6tio.s. ltd tbcy


    thse is th

    thcy DEr pur

    for

    me

    lhd

    d,

    titnc lh@fo.e

    una

    tu th

    fael*

    iho

    th. 3ufr

    l[dFlv6 i! e

    d ftrquilim

    dbldvullg witb

    dcSdiDS ed D.y

    *.tch dd b. qdn ih.it @pin8

    foi plin !o @8., go &d

    @.

    rhd

    .gail

    aviltJ|ll@r

    in

    spab s

    *hich ptin rdicf sqvie pDvid.d by

    ..se, bul

    lIrfr

    hitu.lf a 6onabl.
    lo

    mI @nEjhal with

    fc plin Mtrol-"

    LeFatN infods

    u ort h

    the

    r.li.f ryrt@. E!&rphiN $.1 trhb

    lnin

    sycr.D. wh@ pain is rcghtdd ae

    pair dd olstrrcl str.DIio4 fiis ha

    hmm's faiD8 d.r8ocy, bul this ha litd. lory


    ''D6jal

    wapon

    !t

    shy it is

    @poror. @llatobto.. @mui6ior &d @. .U.

    FsA

    is th.

    ne4

    Im tdc

    Dnhl

    { sln.

    psi4 ed

    pain

    swiwt vdu.

    for n.ding,

    Fychologiel r!alg6i. ofd. adoryhi& r@.tioq ald

    .g.ii$ ov@hdnilg thFd,

    ugal

    l98s).

    ,lr

    individuals h s

    plin p.tiab, fd lh6e irdividu.k pain is dda'din8, md

    n ap.nofthcirb.li.fsFlan, b.

    sith

    pui

    DoDiior wlit

    wi

    opt@ isighis ton thn

    dpdiq..

    viail@ ed

    nEi

    ro

    int @pl it, r.bn8 hy'rctts

    stalthy p.ir. Fc lhcr p.ir is hidda.

    invadc ih@

    for

    r tb. plin

    plin whjcr! lltcy bcli@ n.y iNade

    6 .@i!g sd

    ono pt thcir

    is

    potot

    dlbl. r !as.

    ro

    d.5l

    ddial prcvidc ! hecbdis for uliim.rcly pMoling halln'- (Dmi.l,

    Tll@ b a wide lray of priD in this wodd.

    dd t!:'rndl modaljd6

    F4etiv6
    pain bui

    .Mp6yin8

    6lmon

    3ympt@ io nost of rh.

    Moingitis. Ix.y
    lhey

    b.

    sios

    and

    nild

    and

    hw frtd

    paitr

    physic.l abpl.ints ed usurlly

    dis.c

    be

    lhe

    DpF

    im

    part of rh.

    bad

    tur

    lite blood pr6uE, Lidncy fril@,

    @$.qu6c,

    bowcE loo rstrictd sine


    md ePtqd into thc

    La.

    the

    d dcfiftd

    rh. orbirs

    sle

    waq tujdi9 ofbeld&hd e.

    hadachc h6 beh defn.d


    10

    of

    sDeidisl-

    oalgdicx liL apiin ard N$id olhe @y .qEE


    '"Ihe

    @ ale oomoN NDba of

    for p3in d.pdding on the .dolo$/ a.d inrosity

    al$ Ih. p&riol{ ori@1alion oft[.

    Head&h. h one ofih

    nr*

    m.

    Day

    !!3Fnd rctonds

    to

    nild

    l[@Iie

    s in o@u@@

    th. srbacipird

    of tb. p.jr

    boign bui

    of pain

    d".

    d dbmfon ovd

    T! &6drion

    my oriSind. ir

    the fac.,

    i!

    t*th !c.k

    above.

    ctrslfi.d,tion oI E odtch.

    Lili,lr inlom B lnar b ne@logi.rl rfrdie : lyp6


    @@only

    s6,

    is indlccd

    ii a lmbd ofvlys:

    of

    hedl.lt.

    Mig6,n., Tmio4 Combin.d dd Clustd H.rda..h.. Piin

    in thc

    Had

    l. Dilalio of intra cfuid & dft cBni.l blood v65.ls.


    2. l.ilmalion of Oc blood v*.ls & anais.
    3. Susraincd @rtndion of6c oucl6 in dE sl! &d nel,
    4. Tnciioh on the circlc ofwillis ed ils btuchB5. Ches6 in ifta drial pE$c ed inra @vity pG$c,
    6. Infllm'lrid of inrr. .fuial & dFd tuid sti&rlB including Lptdirg6.
    ?. DiEl pr6uB or nfts @nrainine pain 6bas.

    .Had&he is @moly

    @usd by

    nEold

    psychoSdic heldaehe k lo b stained

    lal.

    Hed &

    wior fo.tl

    Mi.ty dd dpr6sio. ne ow

    ddilld .M sliduy
    eo*ut'(Schmd

    nophstic

    trDh

    or

    eddd nl6

    had&h. i, $. cliddl litu !@.

    Mp.ny

    of

    d Ddclying

    infecton'

    clinicd pr6ar.rjon ih

    wtul wha

    @Dtmled wirb a

    18l.$ing hedr.n6 (c.& ovav..lG d

    .aus.d

    q slnptmr

    .lisodic in nan[, nmloSiod silns

    dd oudsn thc hadste Th die.dd ir likelv io

    strucnnl lesios if sFplons app@ duj!8 od

    re

    ac.9tior

    Althougl

    Connilte
    diaFosld

    Eav

    pla(

    srudy

    Fychological factob Dlsy

    A@rdjrs

    Migoin

    is

    spdtlc

    tF

    of

    ClGificalion oI He!d.ch6,

    eitha \4igeinc

    dilgDoG, Th.

    d Tffio!

    b li@l.d to

    to be @uscd bv

    iftbev oullst

    1962) lhe

    bav.

    ha

    2004)

    idalifcd

    (Ad h@

    ovdhlnite najoritv @

    patials

    @iEd oE

    ii

    of tb6e two

    Tdi@ .td Mi!r!it. Had.c!6

    in whjcb

    ditic.l mle.

    ro th Ad hoc

    coImitle

    deibed s "Rcffiar afl.clc

    fregMcy dd duoljon, thc altlcl.

    Arodia &d Melin6

    pl*de o.

    (s.r|@d A $rdo4

    hal&b6

    94','l of lhc

    if

    b6jln (i,e @t

    lh hcct!.ch. or

    lanq is haiplcgic miSnin",

    s l@y s

    on lhe

    to thc

    ltd

    non$t

    !y sirucnlti Bnin l6ios,

    s@id!ry) if thc s''nP|m3 ocq tfoE th. h.!d&lF, dd it b lik.lv

    Tb.

    9.

    pri@y tad!.16 s.tfuts a rbooud

    of lh. thMb

    ssidr.d *iih n@lo8rc.l .btudalind

    betwo Fiturv hdach6 .

    .!il./ic dietdd. Ary

    clsidl faiG

    herhche is Mial.d

    & S.Ddot, 2004).

    Tl& followins

    hadrch.s

    disdd

    hN to disii!8ush

    Migrain dd Synptmaic nsdahe, s@sdary lo

    inflffillorr, !eul{,

    th.

    @nbadio.! of th. nwis of lhc

    Irad.Cl. hs v&ios @us, i! $De

    r@losrcd si93, ed @

    of

    with

    on th

    of

    Cl6sifi@tion ofHldlalcs (1962)

    had!.!e wid.lv

    vcrving

    it

    i.tdiiv

    e uilltdil iD msd @ uu.llv 3scialed

    naua

    and

    voniting ed

    Mc rc

    wilh

    pr.c.ded bv or

    sssiltd witlr @trspicloN srory ed nood disldtee ad


    Migni.e d vs@ld hcadrche, h6

    Ha4 blilds quidly

    lo

    e ints!.,

    @ijnuou

    drys,

    tqmi

    ftDjlial.

    Nddd oDel n6t ono afrds on. tid. ofrhc

    tbiobbitg Furding

    sd lsls rpFoxinal.ly .ighl hoh

    on

    althoueh il

    @ tugc

    pdsaling

    for

    tuti6

    fw lom

    .@nDsiMts @ eoEn.. nalg

    and

    i!

    1,1.1,
    only

    rlE fist 1in.

    LIigr.in

    i.

    close

    is a

    "lrigdin

    II tu .

    pituy

    CNS

    tdponl rclados

    io cpil.psy,

    Mghine

    . sirel. $bc& wbicl nat nt@

    stct", (schodo
    A

    derdd

    lo

    bui

    s'mptmr host (Fmor

    abhe

    of

    iDstaB il Mv ocd for

    lendary b.rd!.!e" MigBin

    cb{.daiz.d

    is

    3.9d.Ld bv rvnpron

    by

    fE

    r.Pdino of.it!.Ll nlha

    msy individu.ls unda catain

    of prodon6 de
    Blau (2005) ha

    dgtlM
    e

    t dd 'clsic" whCB

    elled .()mon'. (Dimond

    deibcd

    dd day vdiably o@r duing

    c't@n4c

    t'd

    (c,g

    40

    .uthtri4

    fadgue yaMine,

    phas

    dif.Mt

    of Mighiaa

    alt ck in !h.

    FEcdc thc hc.da.h.

    dpdide n@logicd
    Phe, hicleaB

    drlaG

    @qmjlg i! lh.

    & Dall*io,1982)

    $.t

    rct

    uiv.n I,

    !m. inditdual

    dHsiv sldPindx mving

    !.gr!tiv. srrpton . All of th4 sSgd thrt


    hrTothaldus banlps

    0t

    pcs.Dt

    6rn

    Phe

    migl"lrs. h ocists of altdtd moo4 inii.rbilitv' dgrdsior or

    o.cs ii

    6e/6 of

    lpFotsalcty l0

    y visud in Mturc dwinc the pro<lrom.l

    slch 9todmm6

    in

    is

    m.

    i!

    & srrdo, 2004).

    !n.I Fdi.ee

    qFjocins

    eund &

    to

    nulti flcelcd disrda of *hicn hdd p.h is

    p@rysE.l disddd ch{scrqiz.d by a1r!d3 which

    intdrb siDild

    ls

    fltisre faiu6

    qEhili4 '

    th

    mlonot

    oe

    pl

    to s?vqd

    frqdt d! bmiting, pslltr diath.c dizind, paMthdb, hyFB4nivilv


    liSht and @ld

    rl iis

    6 a @lt

    of

    dsiv.

    the

    digi,

    for cnoolal., or

    oiha

    of oHe synPlobs in lnc

    stinulalion) Ih6.sFPtons lsuallv

    phe ofdc nirEitc .ttacl

    by

    *vqd

    los

    or

    4@ it ts

    .id

    qpaisc

    phe

    s@nd

    of

    srhptotu,

    ni8ranc

    such

    is

    ru

    @md

    (the rwo nost

    the

    ln. sn4 cmistiig of ciihq visud


    sympiom)

    sometmd rso aM rFprons

    o.q

    oE

    $t6id.

    rne 6rsr

    dhq

    who h3

    lMlly vieal dd

    th. !h@k,

    r@rsol milrd@us
    tiDc r@6i.d

    .n!.lr

    aura or

    ova 5-20
    and

    !.iz!B

    syDplos at @ gr.duly

    Tbc aW

    jut b.f@

    visio

    of MrgBinG

    (negdtivc synltons)

    nly

    !w.

    dalop nore dpidly

    hin!l6. S@ndly, mjglb. rM

    posiiiw syDplo$. I1E

    .xpqiacd oly orc

    wh.ihd

    .nd diaFosric rating

    wlly

    Agoin

    or two such an

    ck

    fd

    is

    FiBtly,

    visl

    $d

    gndEl ptuCr6sion of e au.

    th

    5d sflsry sFplms

    chmd.riz.d by ! @hiutioD of n gatiw


    s@tom o. hol. in lhe

    ed d@li.C; glinmairy $ittillding light! (lositive)

    !i$al

    $e

    lh. b.dlcha bgiN.

    Fquitcd lo obrlin 6r.iDty, bur

    nigrlinm eipdid6 a visul

    loss. Th

    @s.ry

    Ddbns o{.eltive smory sFptmx ed


    p.tdn6n).

    am synpt@

    lhe fo..l n@logjc aF/om

    pbe@@ TlA, $cb 6 Ah.Nsis Flgq d Hsnimpic


    black or blanl negarive

    dtlphsic

    ndifBtatior ofitdsimi tuch4ic att&k (TIA), Passe of

    tdn f@tu6 @ ndc tDic.l


    of TL{ .nd

    @tly

    or

    s6Mry rynPtons

    befoE Ih. badaclc b.8iB. The

    bln dl@i&

    lhc clinici&

    ssrt Phfth@

    @ior,lly ()ffi sinil|n@slt,

    lppe grrdurlly ova 5io 20 minuts ed usu.lly Nbside

    wlh ddining . p.tidt

    The

    3u! slmpims ga.nlly uurlly ple.d

    sinultlnoEly or 6Mriv.ly.

    Din ud lsudly

    5 to 20

    o@

    but

    or

    wEh6s i! @ordi$lio.

    motor

    word tuding diffculty, lh.

    heda.h. ph& oflh. Dignire an&L,

    thlt my

    nignin. 8fi.ck hG b.8u

    t3ch6 th patient ot ob8daDt fanily ihai lh.

    sdsrt

    synprons

    aB

    rhe

    hed&h.

    uu.lly rsif6ls

    ofnigEin Nally @Nist of

    Fositirc sFptons of tineling o.

    Blrlly

    preeres

    followed by ihe headacn. phs., which is lh. lhird ph4.

    usully rh. host d!:mtic. It i!

    stmt,

    for whi.h

    oB

    5_2o

    bi.urB &d

    re

    oflh. mi8raine tnad., dd

    bqr nigtane p.tiais @Ndt

    th

    "Misnin

    is

    atb

    va!@.stridiE Fior

    to

    ulod io two

    pbe veulu prc6 inE ad 4t?

    sdft

    hldlclE (whjdr in itt

    fom Pbdu6 tb.

    pmdmD*) follwed by a r.actire vdodilaiion whi.h podud


    p.jn

    rub6

    lon ard ir i3

    of

    biocldidl cMts a..dpsy lh* cl@96

    @cl{ wbdhd th*

    bio

    thc
    iD

    @j.l

    n@logi.d

    trobbing badlch

    pqiphdzl

    ahdicd cheg6 @ . prinay

    or

    \6sle

    s4tdlty

    lo

    ilE disrdq", (Kudrcw, 1983),

    r.12.

    f.6i6 E..iz.tz h @ntrs1

    C,trtraclioq PltdDgaic

    pBse

    ostrictior *id.ly

    or

    !d 6ll@nly

    l@g laninS

    rslurion,
    is

    d D.!6sjve
    veied in

    to

    d.fncd s ey "AclE

    int#ig, 6guo.y

    or

    *tsalio. ofd8htl*

    dMlior bd $D.lims

    and

    $b @iilal". Hadlcbe hd . @E iNidiou

    s a {hll,

    rnd h dp@ocd

    slAdy

    bil.t Bl, d bed lik.

    l* id.ns th& 081 ofmisrlile bur Dd) individud dpqi4e


    a

    Melc

    Mignirc T63ion d

    pain

    Uis

    dla &d
    d &h. th.

    tlc

    pu

    of hcldlch

    t in pcM.bly edts tr@ suIlined @ni'ldion of sl.lctal n@lq


    s a 6pds to lif. slr6s (Ad Hoc Comifi @ lh. ClNi6cilior of

    &ily b.ds

    ocMing

    Had&hq

    nel6

    962)

    rnd

    od

    of lain

    is "a1!ibuLd to stimulaiiot

    i$ndia Foduc.d by dprssion

    of

    rcc?td

    in fie

    o.o_&t d

    i!tra-Du$Ia dtaiole', (H.F6,

    1930).

    fifft

    "Onc

    hadehc

    lhe

    vosuld and
    rnd d thc

    10

    d.

    third

    ofol hedehc sufl.@ My cxDaide

    mixcd or CoDbind

    msno{[.l.td

    $re

    nigninc k norc

    of two

    heddh. D?6 @ $bM.d

    sb..ratioN lhc abov.

    @nrovdis rt plBdl

    6re{y viocd N . 6trrl

    (Hsm, Hariks & Ldd,

    R6d.rH s!ul.l.
    3@ D<ldlying c!@ .!d

    Ibe

    qP of

    to

    BUr trln bolh

    not

    uiv.Bally r@Fd

    6Ft i. @nmed wjt\ vhclhd

    nlhd tb& a pciphod dierdd

    1982).

    lhat
    Ois

    'Ms1s

    hoth

    nicninc ard

    16io

    ph6 Tdion ttd

    bead.ch.

    MigEiE

    n.y tpring
    tb.

    nom the

    @. @!li!uM

    md

    srEibute

    rh*

    difrddg

    to

    eaity

    invotvdal.

    of

    Mosr

    tlgclas

    didinguish

    bet*.at

    t"o herdeh. D!.


    TtuioD n .d.ch hs two @l.8oti6l .9r$dic md

    dMic. fte .Pisdic

    is

    rdsion lr?. h.!dach. (ETTII) is dfincd by IHS (lnt dltional Had&he Socitv)
    hqdache fr.qDd.y

    nonlh; wi$
    tnat

    s avdsc

    n.y includ. bild

    sa&ri6 bibldltly
    !,1,3. Mit

    ofgrtq tbd l0 lif.


    atlact

    10

    M
    d

    dmtior of

    hinutd

    30

    hsdahG

    vicim

    al

    pdstile qudily, ald m

    dfti*

    E.an6h.

    c.drhd
    of

    ed

    ro 7 davs

    p[6itc; tiltdinc

    Srtulnt.

    i.dDed

    I4t
    a

    r*o

    bald

    fetu.6

    lil.

    d&db.tio

    Th.mix.dbadaclEsyndrotud5oLroM

    CoDbitution hqdachc is nod Aequdtlv 3m bv th.

    sfl4 lirb

    hldlchc apFidisl. The nixed lFdlchc pllidts


    typc haddclE. SoD.

    fwd lbdl5 *t&ks pd

    Doddlre p.it inltuity,

    Vscde hdd.ch. d

    T@sion,

    finG anact6, but

    belid. ih.t

    both

    nigain &d t65ion

    in scludity th. Paridts

    Digllnc tnd d@Bio

    in

    vilh Dix.d

    (MbiBtid", (Dle@d &

    D.l*io,2OO2).Th.d.pBid!@86'rDskcd'ittorchtunicdailvtdiidtt?c
    hldlchc @nplicat.d by pdiodic nilra@us h.ldach*

    Ibe nixcd h.adach. srdrone is 6npos.d of th. fouowing svmPlonotologv!

    Daily

    chnic ldiotr

    2.

    Ha.d

    d tict mjs&ou nad.clE-

    headacha

    3. I'663!d su$.dibility
    ed

    or Ersor mire Tart Et,

    MiSFinc h@dache
    pari.nr! r?on

    tn

    F!$t

    of halitulri@ to ovd 0E

    (Mrlh4.

    oc.m

    Aom

    odta,

    or

    pr*ibd edg!3i6

    l98r ).

    on

    lo ,ehl

    tind

    Pd modn,

    sn. otrd

    hbtory ofdaily hd.chc lh.l ddonslrat boih ni8Eine dd tdsion

    nircd hddebe st!&ob.,

    @ cl8,cd

    howdd ctNiql niSEin. dd othd

    tl

    163

    niSnine (tugEift widDlt

    hisnirc widts Nv

    ()6

    .m)
    for

    is

    Mc

    nn d hadlclc p6riats, Tt@

    eogi., du.r

    is !

    ihstbilg uildhil ud

    he6d!ch. is slocial.d witb n.Wloacrl

    btw6 ! prindl
    ro

    hadache

    up

    Li|qlrd
    iI h.!d&h.
    vilh

    tldugi

    fnl

    lh

    lcalr,

    ladrcne Th.dierda

    had.ch.

    or

    Nd

    6ms*

    !o

    orc hG to dhiidgukh

    Do pldic,

    nMlosiod

    rigdinrl

    whicb i3

    c .tik?tic

    imFrrt'r 6d 6c [6Iin8

    di$rdd ih@ ...d

    tlng lNtjnS hed.cld

    is

    by

    (.,S, ovd

    io

    war. tr botht

    bri. l6iN, if bsd..bd G

    ny lr6.dc o tcqD!&y !d

    lik ly to b. boig& if rh.3yntsoN

    b.

    last il ard ih qcpiion it

    or!1 head.che

    of

    otl

    e usirl

    !!$i.t

    .?is.dic

    it

    ld

    rh.

    ()ffit fm rh. hadlcb.i


    sd .nd lh.

    Hd,pl.gj6 MiSttj!..

    !@Dg&icd vilh d.rtioa

    6u!li4,

    Inine drf5n,

    @sooBqs, stifinet d D.pill.dd4 uqplain.d fdc, ndic.l

    itre d chsSe ir FEviolsly 6t bltuh.d hed.clE po[d. N4


    im@o @DFmisd parid or ore pbo fdiouly hrd 6lF
    Thc

    didofltd

    b. @u&d by sEu.tMl l6ioN if syrplona a!p@ ihrinS

    if$ey olt

    ldcl

    in

    som.

    o. hed&he infoms r! ihlt th. following nn6 ofth thMb

    .gs6i.

    lit.ly

    sw.

    mts., nonloeiol 3i8E d rtdpkDr

    is

    il is

    Lnoql.dg. ofha<l!.he

    @losic.l alemalitie e ..sd

    &d it

    it

    qmpl mignin ed a srEplomtic hldeh

    di$d6, Thu di.grbsir bay b. diffioll Udf@


    plycj& hat h.vc !

    @u!.s,

    ligff d syurpio4

    u|dcdyilg iof.{ri@, iDo.m|rory,

    th@g)r wo*

    syDD{o! ruch

    vmiting, poDrio, PhonoPhobi. ald blutEd vision.

    r.L1, W.mitsSis"t Horh.h. h6 divdc

    mdiry

    .lsi.Ld

    otr5.1

    hcd&h.

    in

    m6i cl)@@ hadlche disrdd whic! m .lsialed wiih foel


    siers (ipsilor@l

    !$@mic

    6i8D) @ clustd

    hadeh6

    drd

    rlaid

    autonomic ?halalgia.

    MlthM

    (1982)

    tuud Dmiicis! lbs d6ive 6e

    @.t ini!8 .rd8Fsr6, 6sot dqodocy ald

    of

    M6tje dd sff.in.

    ntFhsio. * pmvaalaN Th*

    p6tiol5

    do nol

    altd d@6s.d

    dysphonc mood; lbcir

    poss

    ihcy do mt

    d@Bion h m.ilcd

    ih. sjD.qmton of
    by

    d.p6iol I'!t

    is sad and

    lb.i tujor snalic @npllint, .

    hadrch

    6tbe thd a d@r*cd mood".

    Hislory of mcdicine is dbowding with

    dBoplios

    of

    ditf66i

    tutnol

    sodaljliqbetiwedtot .tr div.fqtslingpaindsh.rda.b.whichenowbelif b


    .o mdit & nay

    bav

    giva

    to King

    be

    hmtul. Hsg$rd

    1929)

    dMib.d lh.

    Chdl6 Il (l6lG85) by lh. b6l physici4 ofthc

    .rhcr.d

    ''A pirr ofblood ws

    ad

    e octic s@ing Fwda,

    snolldd,

    lnt ws follov.d

    Dlas16 of

    itcb ed piaon d6g w@

    by

    frcD hjs n!l)t

    hd.d

    otr

    tollowins
    day.

    hAlf a pint

    bl.cding

    ptg4_bd follNina
    Tbc
    th rcle

    othindjnB ir

    for

    dim@ioD

    laliars suEding will

    bc

    ihe

    tstirS

    '"To

    of

    t@

    nme 3tdl s@
    8htp or Sods

    w@

    hn8 di.d".
    (1933)

    priD th. pdiPh@lin &d thc

    Ddheiss

    !@mplish Ob

    tslnoi

    vho stodjcd

    po6s

    nodel

    mov.d

    the

    ih. pajphdalisr udiz

    lik. ndc bl6k5, a@p!rchft,

    ss6y

    nNchmist

    sfiuclual chmgq wjth surgicil intd@tiom

    ipulaiion of the spin hol paks

    otdjsi

    St rddong pain

    dicrtions d6ign.d io chdge ih.

    e@l Fincipl6 ofpdiphsdist

    bn

    bdd&hd.

    udal}lng

    cdlcd,

    $ch om?ts & nodllitis of


    injmlabls & olhd pardt

    !o

    lris

    s0nng potjm,

    tania8 hadldd bcgD by Pictqiig

    prcducins

    rhe pqiptFnlisi th'nLs tnat if

    paiiqt 6 wll 6

    sror., g.ll ndc

    fi. dt6iE sam6t od $.

    $iodfc bttit

    Th@

    bed

    noi

    hi! fcd. Potim @bi.ing l@

    diffmr $blre6 cli.0y nan! s *.ll s ,o drcF of qr.ds


    sllowd. Fiollt lppliotioo ofthc

    rrstltot

    tuh

    y of the

    tchniqEs

    ed t!e3cutd6!! nde slimulation folloq.d

    viq

    in ltEi.

    altdPl

    lo redu* Nic.Ptiv slinulation"

    'ly

    bslcd

    @ntrlsr lh.

    mrDlis vi4

    of cbtunic pdn

    nyriad of fa.to6 nnginS nbn dE roriors v.ib.lizltion

    vdi.blc,

    socio

    asmic

    v@lional & . v@iional asp*r. motiond Md irtllelu,l

    vs&lB oru. Fd

    @nr.xr wio& which th@

    foUowilg this nodcl pain


    rh. p6liats

    ofdiffifdt

    fdjly pobld

    fa.loE, a wel

    for

    trl6 irto @i.ldation

    b'@E lho

    th. 3@ ofits parb" srd

    difSolti6 m$i b. 6tqr.in.d". (Coq

    interdi$iplinary

    ih. Fin rtialisl


    d

    tucl brcldd viry of

    IE 6E lin

    19?9).

    ptopo*

    lMirirg

    BulB w@ $gasr.d *ith

    Th* istrDol!

    fc.db&lq reldlrior tlinin&

    adivily', (Blsch&d & Atd6ik.


    Holin. 1985). Sone

    1982i

    pr.d!@

    qbB brwa ou bclicft .!d

    fidd

    si8Dfdt du.do

    Pair non

    ofil*

    hav. bd @ployd for

    rwo

    bio

    nad..D.

    &

    tratbdls nav b

    1982).

    lboushts erd th.

    illn.s

    and

    d.lior.tion ofrcut

    thd th@ it

    1983). It is suSgsled

    tuldiodry ofor bodi6,


    lo sard

    ofiln6,

    in@.d

    by

    howds 6tond

    10

    matic mPltilt!

    s.lGlrt6ac. Spdle@s dtueferjtg

    0Dugh!3

    and

    ometior
    tbev

    owlvd

    hlve

    impact oD our physical &d

    cfe1 ou

    Prebole

    ou
    ou

    t.ms of orc h.li.fs dd in d di.lop., my sff4t lh. bal0\

    thin$ w tell

    in

    Hdrcyd, 1986; P@id, Hdby4 Husb

    .!to-innD. systd which nodnde ou .bili9

    *I!

    Edning

    l}d !

    ky.io Th.dP@it bftreldotr..

    p.j!", Gunq Meichobdr & CaB!

    in

    t .db.cl

    lrelndtalorc', (Bltlddd & At&!er'

    'Difrsdt @e'itiv. stztgi*

    disd.rs,

    bio

    widdc sulg*is thlt "@bin.lid

    ffi.ff..tiE $e.i.hd
    1.5.1.

    nccd

    .ppoch.

    Bhavionl jntdanion in tratinS clrooi. hc.da.h. wa stinulai.d norc

    d@dc rgo,

    Milv
    thll6.

    dotional well-bing

    ouleb. of @gitiv. lhdpy, rclu.tion taili,lg, aid @SDitiv th@pv in

    @hbiD.tid ei$

    cludio

    Esining on cho.ic loe ba.l

    lajt

    snd

    @i!r.d

    phFicd

    ard psydo$oal dhalility w@

    dalut

    d |nd @DPucd, aU

    taEHt

    rdain.d siEri66tlt impDwd fton prerrobn@f', J A T\n6,


    ''CBT inprcvB @pirg wirb ptin .nd to

    sa!i!8 H.vid d Fib@t|l8ia

    . Ktrhrin

    r.de. d@63d

    3FW6

    1998)

    Dood &d

    hal0tce

    A Nidl.f. VoLdt .6[rB wBh.d

    (20r0)
    Applyjlg ofFyctologiqt @BEEt io had.h.

    for*rd,

    inc N

    nor @8niz.d ttqtDots

    for

    P.i!

    di$dd e

    disd6

    sidpl.

    !d sf.igltt

    Bpeialv hetLc[6.

    Fi!di!8! showth.t @gnitiw pDto@k @ Gff!.tirc i! rcliwi4 distts' studi6

    l@m6d
    whm

    tbrt

    tbey @

    shrdig should m.loh intd@tion lo speifc

    "tutw

    int6de4 s v[ u lddidonal 3tudie

    lpprorcbq ktgtthd with

    @iii* i4hiqc",

    that @nbind

    ch@l6islie for
    phm@loacd

    (KuPD.dEind, w@d, BmM

    Roold,20n4).

    Psltloltraay
    ch.lldSi.s

    .@ut

    f(rc

    qFno6.

    ot tb. cmtiotd

    siil6 4

    (190) Polot

    of sch

    Fr]66".

    Snrdie

    nril6portly liSl o

    @Snitions nay inde.d

    inrttios,

    b. cfrctivc in ahwlring clinidl

    Ei

    lttis

    bv

    dificult .rd

    e "aiDildion nodcl a a aosic

    n@hrnw dd $8gel rhal'ngatvc

    rfr.d tratnot oltcone" (Bm!, Kubilu. Bn hl' Ilado &

    d Psy.holh@patic

    wirg

    .1.

    pt!! ossrded

    pra

    StudiB rcpons rbrl @etitive strigje

    Ryh6tcin 0979) fould lnnt

    mv

    rnicninm ian

    aDdrrivc ad adatior di!6i@ 3!rlcgj6 sho*cd erar- atrautiotr of p!n'

    thd @n[ol su!jdl". BrcM& c1Ev6

    (1984)

    hEdth rniSEil]datauehlo@

    iru8iEl oping st?t gie Epon.d dd6.<l had.c!. !.tivitv

    @Fpard to Plac.to

    b.
    coping is

    d.6ftd 4 prpo*tu| .frorts

    'AppEislr .d
    by

    & @pins'!ain

    In nodels of shes

    i.flhcing

    (Bardu!,

    197?;

    idtiltio.

    l,ru,

    &

    chrcoic pair @6isLo1 with

    on

    198,tj &

    !6 fic ibility

    ad

    srB wh@

    Laal! Folhra Sd*rlr

    to play

    ot @pin8 flone md

    6tr.l

    (1966).

    ble in thc coPin! pro<s

    otsdl stuc ofeel b.ing".

    @.

    of ih..pp6!sds

    ndi

    importel in ad.plttion to
    1986:

    bdagc plin

    lo

    have

    ddoNlold Fsitiv rclatiots to

    ad!$i* Frrholosicd fii.*ioning". (r{fie.t r|e, Pfifc & Fitndd,

    198?).

    Relltios bdwa

    PG ivd" (JeMn &

    6r'0l .lpni3ds std .diYity l4l

    (mly,

    Additi@dy "Drti6f t
    rcldcd io @piis .frorts",
    proio@h @

    lferive h

    3.N

    of

    @ftI 06

    (JclM & xely,


    r.ducing

    1989).

    @nm.d

    with

    !d

    bc

    e "ainibrio.

    th.l'lndslardin8

    Desltiw @gDtion hesd nay i.d..d afiel

    Brue , Hdda & Nod.4 2001),

    lo be

    ittdono. b

    of activ. @pi!8

    rcsrlatd !6rtjopafion bv the pdi@ls)

    phFi.d nDcriotitrg", (BDm a

    Stjl6 (1990) prelos.d

    b thou

    & Ro..l4 2002).

    ddorsdal

    the

    p@ired p.it irlmity whjch My

    Studid seg6l

    sbould nalch

    & i ddd, (Boh

    s d6dF thlkcquirc elf

    ofpsycholosidl

    ro

    studid propos thal osnitiw

    pai!. "tutu s1udi6

    l,h.y

    ba @aime

    pain

    Rcdchcs sbos/losiliv. rclatios b.tw@


    sratgie tuh

    d$ iad.d

    ha

    989).

    sreitc chmclai$iG fd {hich

    pl1m".

    of

    34!nl lh@r.tiel tud|s", (B!dur, lg??i L.z|N,

    l@l!B

    of

    're

    S.ligba4 | t2). 'Ef66cy judgn@t o. @n!l +Frisls b.licfs that

    indi6

    indi6

    !!

    1986).

    Stldi6 hav. l@e'liz.d

    Follbrq

    d66ibd

    ndlgc it

    abo p.in @blid.d

    beliG

    bolh ihe

    ro

    is

    is

    hodel 6

    Ni6iq

    Potdi

    tatml

    srudid

    vuall. th.t .frdts

    ! g@dic

    of P.in hertm@l

    1986).

    sd

    .6ut

    ptoes

    our@tu

    of 5Eh

    ard 3u88.* thar

    (Bbq l(ubilu,

    EMD& Elr

    no@d

    modstily which ddclops coping srd


    for

    trlM.

    ddqtsitialio!

    Edlc

    p.in.

    (Shrpno, 1989'195) and hs b@

    .Dd

    ..pMitrg

    'fhis ndLod wa

    is d

    us.d

    lhdpcutic

    s . !4!tar

    .clmwledg.d'a effiqdos

    O.
    'n

    trqtbot ofp6t itouailc

    st

    4s disord.r'', (Chdbl.s, GBc.ly A EHm, 1998j

    chdtob, Tolir, v&dd & Pirne,

    talrnor

    Th. didc.ccd blssd

    *to "qeir.d

    "clsic ed

    h.ldehd wd !grn in

    Mdi.gd clinj.

    proc.d6 w@ ll oily r@eniz.d fms

    found

    th.i trulcd

    inc6.

    oltrmpejd @sailon of @cniE h.{dachc'pructio@


    to

    iltdit

    hod t

    Dpallft d a ndlod of dalilg wilh

    fanr.ofut g6ieiboap/'6{n
    fe.dbet", (sl4sr!
    It is

    Ga & w.ltd,

    ill.ruliry

    lhar

    bed

    hy whjch thcs. snuctrcs

    baomd wmdby

    h.fl

    rotstiE @id@e $ss6r

    &

    Pi.*ding

    of tr

    blood

    iti.d to fild ways

    misdire. *llEy ttld.d cat in

    en 6xed

    lhjs

    blod "tuloadic

    1973).

    l.!ds

    10

    inprcvdat

    in hd.ch.
    th

    ldiviiv

    6ngd h dt

    d thc.ndiol6 & dpilldiGbediig dih.4

    tlc hnd my b. rh.

    rEduodon in

    diladon ro @cu, thu it is sp@laLd thbi

    ct'idoa!6id

    syn adaic tom it

    thmd

    of!.rio|r (Sov4

    synplthaic

    bio f.dba.L bay b.

    nms rynft.

    s.ftl

    ne*!ry

    bio f.dback may b

    lrrnp.th.tic oltilow which mly b. uctul for lboni@

    $gad drt 0rmal

    h5,

    Bl@d i! incrcls.d &td the sufde of thc skit

    bslinS fest r

    vselq od .

    $Dd

    Lsp.nnne

    slmbad & Dal6io, l98l), NorcN rysid @ltrolslhe costtidi@

    Fipbdlt

    redu@

    1969)

    in h&d

    al lhis clinic

    v6olatuF oflhc hodr ed

    rc wded,

    rbar

    hdr,

    vming

    Blood flow ltuouS! tbe paiphdal

    Kunzd,

    1930h by

    otb* had p!ir"-

    In 1960\ ndiel

    alailabl., in

    for

    olc of hilrmiB ir FDdaing hadtule" duinalbis liiC', wolf

    thc

    (l9E5) wroi. thc

    2000).

    or

    for

    of

    th.

    Fiphdsl

    d indiot

    wav lo

    Dg.ine, nndins

    ir dierdd inossd @$d of thc

    In 60\ ald ?0t Eud4rdki, Soyv. & CoU@s!6 (19?q .ni.ul.t


    sunlin.d @nf!.tioN ofst.lr.l

    individlri strlfrgid lo rcdu@


    and

    had.ch..

    ft. p!6.de

    mql. led

    b had.dE e n

    th* @ntidio

    they

    d4dop.d jlvolved nditori!8

    dbl.

    nuel.

    lone rhat

    dc.@6 i! nt or pirch s nNcl. rld, hs

    .nd prcvidins fedbsck

    f..dbtct

    Sloyva &

    1o

    ard

    EMDR

    b6

    fo6d

    io bc

    in

    lbey

    for

    pdrg.d .ppl!&h

    qpqi@6
    siiution!

    pG*.i.g

    to

    whjcn is

    rhat activates
    is

    fd

    Th.Ey.

    a 3 dannal tor

    v&ds & Pi!n['

    l@8!iz.d s

    (d

    being
    a

    d.

    kind

    2000),

    EMDR

    ba

    of th. prilury tul(

    of Mall't" tr.ma

    ReprocsiDg (EMDR) is e inlegnlivc

    osisl

    of

    bodyst

    psychody@ic, osDitive b.tavioEl,


    r.d

    lbdpi6.

    DMDR

    pslthoth.t py h $ cidt

    side Edee ofplychoPltbologid rr

    which @ GDo&ibale h!v. 3.t tlF

    gtuudso*

    f{s

    lo dE P6$

    for p.tbolo&/, lhc

    pt66i

    dy*grrlated motion! '"rh. pdDary 1a4d tur EMDR

    $. oripnrl incidat, in which $. injuy o@Ee4

    Th. bsic EMDR


    _EMDR

    ald

    dbat

    choie

    !d R.P|gbg).

    cl'mjcDoi! fo. | luDbdoflt.$G

    Movdol D*dsitiatiotr dd

    D.tui.l, dp.nalisl,

    of

    hs bca rc@gniz.d i! rh. irehldt of Pdt traM.tic

    F.ua

    psychorhdpt .ppFacll They


    int

    in

    t66.d (olliv.Ld eu!d)"

    facior for chmnic pd.". (sa!deG,200i). O) Chrcdic Pain is


    Ey

    ldior ld.l!

    (EMDR) wa introducd

    d. 2001; cndtob, Toli4

    b. nql'rat
    .tr djvc

    dl*ildon ofpiir

    bffie a tratrot

    D66dtlrtti@

    RepMring

    (1989-1995) "ard

    srrs di$rdq", (cthblB

    [a.h lh.

    Budzrrrrj (1970) "sDd.le lbnt AdiarfoElad EMG bio

    1.5.2, EMDR (Ey Movemot

    t"ma, Shlpio

    to

    !o

    psti@tt lo lowd lhcit tdsion l.vcl via

    r'lduc u ovqlll sIde ofrclt$d@ *hic!

    novddt Dedlitizrtios

    inporrol

    whcl world lad

    forhead

    t6ion h6dsdC',

    thl

    lra@

    preto@l i5 re.d in this

    or th

    tpplicitio"

    q de b N.d b trsd thc e4do ofp.i! .!d dsts

    fiBt tin. th. p.in

    (Sh!p,rc. 2001)

    .bool syDpioN

    ..d

    rclated

    dieliliti6", {Gtu!

    tallot

    Stl'di6 show thd "EMDR bay b eftociou in th

    1999)-

    sa t watuld", (lvil.y,

    ofcnrc.ic !ain, 0bugh ndhd Garch in thb

    2@2).

    l5J.

    Bio

    Fedha|.

    Bio

    fedb!.!

    individud is Fovidd Esulsly

    f..dh*

    f..db..k

    is

    irdividu.l io

    @nbol

    phtsiological

    to help Ih.

    lovided

    !lr@8@o! t@porrl attdy

    la.h

    ltr

    d opdet laming proes

    in ehicb rbc

    r6!oe

    (rolysE h),

    @ r sFci6.d Dbtsiolo$/

    l.ding

    10

    Ad.2

    Bio

    tud

    tEtmdt |pprc.clB

    to

    bio fe.dbad.

    F.el B@b Th. go.l ofcmponl ersy bio fe(6!.1(

    rd@.rcid ve

    Mll b. r.ducd. Ar d. last lL. ifidsity

    rheml Bi.

    lo niSran hadacb*

    thm.l .l@iromtlgnphy

    pllidts to Edue pd* dplitutlc TlE patidls

    @atlu.tiv si?!t &il

    $lfrg]rlalc ad rcldi'rily

    rs?osc.

    Tb@ @ lb@ bio f.edb.cl

    Tehpotul

    tu

    FeenbnchBady

    i!

    dihtion

    .d

    thc

    &

    ldght

    !.ir m

    non r fngd. h.s

    volm. hid'd t@p6&t6 indidte

    volMe thmal. bio firdba.k

    nds

    .dcciilg

    patidi io incMe

    ELM
    ha al$

    fc.dbrd is

    ro

    to

    F..db^.!

    thb wa Bd

    bat nie6in, rb. It@. i!

    !rd!@ el\.red l@h of n@lc

    slmldrhctic Nusal. It

    r.t6 f4

    rclhe pul* d led tdFrrc


    for boE.

    10

    p.i!

    in6d

    blood

    r fingd dd tdining

    ih.

    irgd idpdtuF.

    1he

    MroCrd?hi. Bio

    ucd

    lbmistor

    th.t rn.

    b6 !.d a e

    bl@d

    v&

    b. si!ni6@0y

    Fiphoal

    itrdil4-l Ea$e of

    10

    ir llr

    @jn

    t@F .l4tc.y e

    dMti@ of ltqd

    ta pat\E

    10

    ro

    ontrol

    d!@

    3ir6

    @ al$

    pEctie ed tEiDiDg Elmtio! rE!i.gj6,

    Ituid

    hdrh.h.

    eldiimtoenphic

    t@i@ .rd rhd

    nBl.

    Th. .mo.y

    ro

    lo tr@l

    by

    irdin dy

    $4 tdp@l

    Ii

    lio

    to

    Fd@

    anqy blood

    b. ircEsd by porr.bl.

    uils

    Sndi6 hwc sboM "Modinc.don ofmisrdn Hadlclt6 by

    volm. pul*,

    "Biof..dbact qth
    .tr@rive for l! trE
    etr

    div.

    for 1h

    inpro@6t

    Haq

    drd EMG Biofeedbet , (B.ld,

    tndl ofnienire.

    lroM

    to bc

    nrc biof..dback-asist d autogqic trainjng i3

    rarlndt ofmigr&r. .|d

    of rh.

    0ldpdtic .fr41

    its

    uicty ldel"- E@-Ho

    clo*ly rht d to thc

    K., J@Eon P., chiGSmS c., ( 2008)

    tdi6

    Ma&&rlysis of stdi6 irv6iFdnS th. cffdrs ofbioft.dbtrt m

    had&h6 ws q@i$d ard Biofdblct


    nonilo ing, pl.ctbo,
    h.!dah. "Funld

    fould lo

    md

    be Dorc

    cff.div. lhe nedtch.

    inprcvoals Eultd

    si8rtitdi .trels s@ ohdcd

    dictyi depBsiot\

    symproDs of

    *s

    rcldetion thalpy, Th.

    snd

    Blood

    & Ad.ns, l9?9).

    wilhoul ombircd autog.d. hining is

    or

    c4[.tic

    fm

    lor tcqMqv

    nMl tdsion, self{ffrcacy,

    arlgdic n diqtioA

    biofeedbrck @BtituG3

    .fleriv., did.n6brs.d ilalrnal oFior fc tdio!-typ. hid..ne" N6totilc


    w' M.ni. A. Vd!-.r'dysis
    Biofccdlek ha

    wo* ws don ir
    for

    filding! Adn

    lotr8

    bd

    biot@dbact

    ney nt'-malyr6

    had&h. . AldEil(

    u!.d fd r.dEirg
    rcpon.d

    iD

    rhc

    syttlt@r

    lhe l9?0s

    of

    l,? ft@

    fq misrde, ind lus sPpdt

    lffit

    iD

    blmd

    0E

    is a sa.ng

    My im.di.Lly
    rat.,

    is c@is&nl wilh

    errdr.$ing ooi only nigrdne bul als

    lmon'llF

    "Rcldition work s

    ey dagdcyl
    etidot lo sit

    F*ure, sli! renqcd, h.d t

    ture

    n is

    ..3Ft|d5 wirlr physiel cb4ge whicd lad to

    bsrhjra nL, hctaholi@

    body gds .quipp.d to dil wnn

    Iows to iltc bai!

    spFn

    F,. (2009),

    pBE ! E6t

    doM, blood

    Ri.f

    hadacb!;

    lj.a. R.lstior Tninin& Soss t rd . toll o! ou ststo" *bd


    qFi@c.d

    Y,

    (2008).

    the 1960s &d

    th.md ed EMc

    of

    .nd Uood flow io

    prclonaed

    sb* 6 lwll

    s3", lne sJmpadtic

    .ems

    inqle

    f,el6
    in

    Thc

    h.d!chc.

    svstm slow!

    dd bqthins nle d. idn .d Bl@d

    Tlc c{t dol@irc's (iltc bnin


    B6in

    cldicd) lhd stiDuhr bddld.

    w.!6 b6me mft sFchonjz.d dd pbnotirg cdn

    nBcle idsio! de1)@6 h.lpins

    Deep

    bod, io h.61. A

    th

    fd

    gqlq

    dd

    63 ed reldotion,

    c{)Mor y pEctic.d l4hniqc

    B@thi.s: Rr.&itgde.,y thrcqgn you noe

    you bnii vhich sulting ir

    is Edua.d.

    athdc

    oxycpn flow to

    rcldalion.

    Ar'ogdi.Ttui"inat 1!i! ldoiqE !5d sr|ggc.iid to olee blo.d flow &d

    hMlc

    rcduc.d

    tdsiotr

    sq@@ of body.

    it

    b. N.d wh6 lhm

    Empl., I m

    calh ed

    is

    l6d&h., Aulosaic Flining ha

    r.ld.d,

    1J.5. M.ditrrlor: Itjs inrclB rcParitg. wod or.

    El[d positid witi


    Am

    the

    .loscd cyd .nd

    nind ed h.lF schnv

    insru.ror

    trsrbitS slowly

    the @ndition

    waut 8iv6 ! tuh. whid

    This

    leMt

    @dd b. ArLAg

    @brq phlsiolosical

    Nw.l

    '.

    6po$q rcldtion

    _Mlr?'vtil.

    you'c

    *@3 olbs lLoughrl awav

    for abslute

    Rcldaiion (pmgBile rclaxali@) is widcly uscd


    rdhniqu ro piodn s r.lu.rion

    rela:ilion Th.

    OM

    ed i! ! vdv Fwdftl

    tba.Py prcdu@s .frels in which

    Ble.bEd, And8iL, Nfr & At@ (1982) "in

    n.taDlysis ofavail.ble studi6 dployiry r.lu.tion bio fc.db!.r FvclDloeiel &


    phm!@logisl pl@bos foud, Ior

    mbimtion
    fedblck

    of bolh yi.ld.d

    t6ion

    hodscbe bio fedback relaaiion

    dd

    3igti6ml impre@t Fd bieni!. hed!c!. dlogaic

    sd rdualio tait!@t p'Ddue sPdid oul@ff "

    Th. dcalalins fr*t ofoulogaic

    rerrndr p@.d6 6ll.d vemotor


    b panicipots @

    laneht lo

    ddEicl

    bio

    tms pati@ldlv
    f..db.cl

    blood flov to

    sl$

    ue full Bio

    s.d

    fedback

    Th slbjed!

    .bdt mighi*, il il

    al

    akd

    d qFitmlrl

    'admdon trinins
    Willims dd Suwil,

    is

    l9E I ).

    dilizld fd

    rd

    il5

    ditd bus4l&

    irs Educdon of

    g@ddizd

    Mcli4 I983), fd it! @griiiv. efre.t (i.e., 3 a disttaction

    eff@ls" (.8 K..fe, Block

    mual (. g

    Liniod

    &

    ailotion div*ion straleey

    or

    dforiBirilidPl&.lbvtloe). Reh{tio!pm.dlc@1bc$q.sitlvutilized
    vithout

    fru d

    prcc.dlE. Thd

    @8njtiv

    tu

    ida"divc

    rb.

    o!'ritids, hdEvid ed doti@s. nF thalpitl h!.i idatiry


    oflh
    risy

    ste..doi stimllu s

    vill @rtinE

    !o

    Rd@$6
    eith goadis.d
    rcla:*ion

    well d the rdPoN.

    Finfor

    ln p6'chophysicll

    h.!G cpott d th.

    dicty .rd

    r.fi.nt

    nay @nnihn

    T.dqs!, Edei.d 8.,. AndEiI !., Su$

    trstrndt
    E,

    @!,titivc

    ifth oStitio$

    @FMl

    Maltqd

    tdedlid L.i.iog b patiats

    of.Dpli.d

    vilbl, low-@n

    in thc

    the

    EiPrcc.l rcle of

    EpoN,"

    !rl!ck. sn)di6 .ls

    panic

    dp@ivq cliricbs.d p@dlB

    .fio.y

    bd$

    atrd

    of

    ea!

    th.l th. hoh+bls.d

    .ltmlriv.

    to

    t'.

    not 9pical, bui

    rdj@lt !d&h." Stda

    Jui!b., D<ttn F Ncf& dd Jobt

    G.

    J.

    A4

    (2m6).

    1.5,6.
    w6 effectivc ir

    PLc.bo.
    35% of

    Plac6o is a psycholo8c.l tu" Bachd foutd th8t plac.bo

    i, psi! 4@

    poti4ts

    Fliding lh. otrdition, Plactc


    .nif.crs in

    ph@loAjet

    @nirib ine

    ro

    pl@b

    'gd'

    .tr.15 in

    dEuS! inc l.edEii

    i!

    cpoe

    gaazl dd

    .xp.dancy nodcl,

    Itft e

    qp@iancy.

    (Kiu\

    .ctror

    no

    @tDl, "Phc6o ctrau

    pl.@bo pain

    1985) aid lhc

    two

    dudjon

    in

    s
    . vsi.fy of meldis hav. bd hrpotheizd s

    ue.d in p.in

    include olssiQl @ndilionins @jty rcduclioq fie

    cbodge

    tc

    Es&dcd

    P.tticdd Thae

    t16. ofodogoous opio& sd

    min thdi6 ofpla..tD

    @idition.d E

    lo*

    nod.b"

    .crion, l[e letbal

    (wihuls.r.ra

    r980).
    In ltle

    llc triDot

    qp@l&cy model
    thdt

    irlo b. giv6

    the

    patidls dc hlde to

    tbrt .ll l!1a

    dpqiae

    qp4r a cdain
    is

    out@n,

    @uEu.d frod ilis

    fion

    dpdt

    tion.

    If. plliat

    fmly th

    is told

    aFi.tE .id

    this ha @t
    The

    Ee

    b6

    il! +?Uerio4

    !i.ld!

    Ibat

    b.

    the

    @plidrid of

    uwillirgly ESdd

    & Prie (1981) $egds lbat

    thc ddoiphin mcdi.rd systm

    rbe

    @nfm.d".

    ondirio@d ropoGc nod.l

    rctied tEr "dE dos! b.se

    re.lizld

    p3in.nd

    tr rry

    bclid.

    "dpet tior ofimuity E@ p.i! ..1iv.r.


    widoe fo

    rhis,

    R.dads blE light ad iflh D6ri6rs rdly

    plh ey so!.1ion h.

    *illhav.

    cm6 fron th wo*

    ro

    !.livat

    bcforc th.y @uld

    r stinulus cmplcl|ly

    ral'd

    in

    of Paviov (i

    !c d m.U

    97,

    tb.ir foo4

    i$.lf w6 r.pstdly pffitcd b.fm

    lF

    one

    (food)Ihemmalphysiologicdqctjonof ssliv.tionwouldlle. @wbawapply


    dis nodel to th. placlo

    phmn64 n k +psdt

    tn.t

    ltt

    n@rid 3tinuls sucb

    o giv. r.l rdid nlD p.h berw lhe !.1i6t ba


    !@ @odiloDcd oq th. y6 to dFi66 &.lg6i. followirg lh. r"rloqing of
    {nmy

    taut lmldrg

    li|. .5pi!i!

    Placto should

    b..Lfnit ad

    lhc indjvidual aniMe &d


    lhe

    ndd

    pdiol ha a positiE !din|d.

    T! plcbo fret ha
    (1997) ll

    tu

    e spetltioD

    to

    rhar

    i!. lubj.diwplmaa

    irolgly b6lv.d, piin will o.iy

    bc

    in whicn

    Elis.d

    lh! th@py sd 0E qp.d6cy tbrl plin will

    dctully d.6ncd saF M.ybsg & Stodsl

    whlt yor @ b.ing offq.d will h.lp


    it is not norhing".

    the c8p&ity to g.r

    if

    te

    yo\

    it is mt rhe

    Ifyo! b.li.v a lratrnat wiil

    w.ll you nry lciully

    have

    eohtion

    hlp you

    of

    you

    e
    e.g, pl.c.bo taquilib, 6 lowd h.In nr. ed blood FM, sh@

    ''Placho

    p@ted

    sr!1. ir

    !o b vEry

    loeq ofpditive thinline, ed


    dd ifyou systm h$

    ltong, P.h

    effer! dioic th. .f@ls ofddgs, ir th. Cuie ofshich,

    ihey

    pl@bo ltjbuldts @

    w6&

    1963;

    incjte h..'t dc

    Kieh & weix.!

    @m61cd wirh $?ets ofrhc

    slelhcop.

    lhe

    bru

    chsgd

    acrivatc dE

    fid.d d.3r,

    s.

    !6i

    M.ybs A

    Bpond to plGbo!

    qpaiac.,

    dicil

    pathw.]s

    $o*l

    medicina. Placbo

    etuly

    A.ddinS b Waga

    (2004)

    bs&

    of th

    drug

    is

    "qp@trti@ ofhow wcll

    nar.l p.lhwry 4 F6q'priv.

    phab$

    d@

    rh.

    bais Gpo@ b

    p.iD ia

    x in dE

    u.d frbcrid.l

    hdin ofpdticipei!,

    the

    .ff.d

    of

    cr they

    otr

    p.jn

    orbibto d

    fl.rd nahdis.

    wirh

    n6ud boin dctivatio4

    pl...to

    prefonlal ed

    In the

    wd Miar.d

    @ncx

    ffind

    s6

    ir rh. plin

    obw.d

    ih.t

    qpsi6@ ofplin

    p.i. irdlcing clelric

    in

    Gpou.

    Gflel @g'iliv. @ppniek oIp.iq

    r.ld.d

    in

    10

    olod

    p!i. natrn-

    reli.t

    d(fuhrqd

    life

    ole

    of dE plac.bo

    b6io activadon of0F pain

    n .!dim

    ortrbl oflnado. ard

    othor hr?oi!6i26 th.i

    or

    in th.

    eiib .ctivrrio in llc

    ofurc brajn

    eIaior

    th6. Egion h

    to eticipation of pain

    rtudy h. inv6risr,&d that

    r6!oi*. IE

    in

    @d

    rduction in rcpdted pain in

    d6as.d &livity

    foud thai plabo b.diar.d r.duciior

    late

    MRI to 3how tnal

    G6r.h @npa.d .ctivily

    vs .ssilld

    pl.c.6o amu!, vhicb

    ()ffi.d

    a6

    '!6ir Datrn" O. rhaldu, $naro, sosry @ qr, in$la

    Wasd tho

    etr

    drus or

    cnegc il,e vay that pain sigr.ld a proc6$d in the bnin".

    pl@bo grcups witb lhat in a @DtDl grout th.y

    Th

    .lrard".

    sno4 lc1ivaI.d r

    the

    ily

    worlq

    s F*iption b.dicic

    0 99?) teXde lhal

    Wass ed his @llasu6

    on

    n@ing

    d lurgdy

    sems to od for hagnitud ofpah erp6i6e'"Tnis $g86ts ihat thc

    elly

    Wd &

    ri vhitc @r1! ofthc dodor.

    of hov w.ll

    ril vqt my .cnr.lly &riEt llc 6c

    sug6y

    Jarpe,

    th. rh@Fllic ..nin& all s.r lh. slagc for posilive

    nairSs qp41ltioB

    of thci.

    blod pBse", (Fruld,

    1988).

    u lhal popl.

    L.rEtue infom

    and

    tne

    lcl.

    o.tix

    d.@

    nay

    uiseptd by prcl@8ed p.in,

    well

    mid bnin

    dring

    the

    dticipation

    othd r.giols of lh. bdin 081 midt be

    oflhmal pu

    (2002) $8g613 thli in pairl


    in th.

    dticipalio s

    nlintlin strlt gis

    noddating, bo$ rh

    oppos.d lo th.

    givi, ed thc

    thal lhcy @

    dte

    do@l

    rdiel adivltid

    qu* ofnoxjo$

    stjnuhtioN

    Fc.ltion

    irt@ci!8

    0F

    qrdt

    th.

    tnd or

    Wagq

    bnin re8tom tuv be

    bo3ft

    Mial.d

    ro whicn

    $bjett

    of

    in

    "

    s in ParkiMs dir.e difrdt

    ''Exp.<t!D.f plaF r sl by
    Md

    in its

    mE dit6{y Eldd b th. tsmision

    psepiion ofpain ws nodulaled latd in thc

    i.rclwd

    dldid a

    @!6m.d'1h inportare oflbe dos.l.ldl Prcndd .rd r.61rdl

    This 3tudy

    sith

    inpldol

    givd, Expbtct pla6 e iDpon@t reI. in

    to which subjc.tt

    u.

    thc @gnitiv sirat9i6, th.t th.y

    of slbstqusi pan rcdlclion thal th.y rcpon', (Mdi!o, Md*.11,

    G$am N'.hola & Sp@t | 93e).

    Py8lldion Eff.cl, BEMrd sb.v cxpli.{6 rhc ida |har th

    r@G

    erhq m,

    tul6ltDd1)".

    cs

    Lh.

    inlMccd

    parior

    wors., b.

    trdsfming cnE

    intumc.

    pati4ts

    on

    lotg

    @8dt

    l..lth, whd

    oulcme the efrqcy ofa new drug

    by lhe

    ''Plrcclo

    fte bedic.l pmf*iotr h.v.

    hsve a 3!o.g

    deffinir.

    for bdr6

    Prophav

    thtl

    or

    td

    Bpos nt6 vsy with thc choie

    of prinary

    chdldftste sd $dy

    1,5.t, Medhtior,

    The

    prcloneed sNpadd

    os

    phlsicis .xpLrron

    a Placho

    .mcv

    nov

    e'Iet"

    h..sc $ w.U

    d68D_. Arlonei {2007;

    dcidt

    f.dnions of.ll

    olnt6

    Fychological @nlml prloded by ncdiialion C!fuwho would

    h.!! b

    rl3

    trdn@t @ b. g@tlv

    rcf.td 6

    cu6

    they have simils cxFciln@e il

    cdl

    phtsicis dpelrlio$, $

    *.v o!. pqsD

    4itr.lion to prin suPp6ioA

    potiav fda of

    voluldilv

    nop lhcir

    celrci! ale

    ddnostltrqs

    dinic8l eficacyof rnedi&tior in

    ine

    hsiructioN: SininS

    ese ofD.dical

    widc

    @ndiridrx

    dilarioD

    et !e dkndd fd

    Do

    tL.

    Ert

    20

    nirurs,

    d@ ln. dod.

    Sit slr.ighl in th. .hair, Ir you slouldffi drop, Cloe you y.! & it

    2. L.t

    no!6drs

    tbe

    of

    nucl6

    in you body

    tou bdrhc i! lrd o[r

    r.ld, f(}se 6 you bEth, sindy obw $e

    of you @strils.

    3- Do nor ler you ariation w&dd jun

    ifyo!

    gt

    dist!.Ld. T*G

    and

    4-

    a rcrG

    clinicies ed redchas wirh

    to

    !.d@

    expdiace

    ie

    Do mt b. up6a

    b tow bFin,

    rhat

    ibe

    s@.y qpqiae

    ocm wh6

    bdagb*

    of

    Fldy ro

    Krht-Zim (l95) ed

    ls

    timc

    'M.ditat@ t4ps
    ofpoin"

    1,5.8,

    dli.ipdidg

    the

    ch5l6

    |@,

    suggBr rhal

    plia bul61hq EdlA l[

    pai! is sticiprrd, Tht


    of ln.

    and

    i! irlf opp@

    qFiac.d p.i!, ed

    tbougb rb.

    ro

    b.

    sasdy

    uncnmg.d. Medilalion irains th. brain to bc DoE pBol-focucd

    th@f@ lo spod

    cxFiae

    dm

    gqt cljnj..l cff6tiv6qs. 'Tn. 6dts

    c.b68. rhEw

    dorional 3F.

    mlet

    rholgh r,n

    of Alddhilr qiein ba ben N.d by

    fttu rrFDa.h

    n dilrid dtu\

    of}!u

    fou @,oubElhing.

    ninuld gRdully opo tou .ye. You m mw ||ar

    15

    fcls

    ed

    tuu nrliE datsr

    bind AoD &ticip.ting pain ald

    so

    dulh

    p6ont

    {2010).

    Di.f.cdol

    Dstlctior is.ftetivc rE6tgi6

    to coping with pain.

    turad thlr m etrcisr ey ro dql eirh plin or dy &bdbL sin[tior is


    io distncl d*lf non the wlion d upr.dirs flotio.al rdclion wlicn .d6 non
    R6@h6

    rh. .gonizirg nihuhlion, DbE .rion is nLd

    ht6ly a r

    psin @ping slrarcEy.

    1,5.9. P.in

    $d Medory. R@lhdlhft irfm.d

    pdn

    {d nmo.y @

    thcy

    nitular. els whicb

    l.lding

    to

    ru l4l fd vek9

    Mys-

    Nd6 @y

    pai. sie.ak

    inpliqt.d eith nati!8 |]@di6

    GDoNblc fq @ntriburina

    is a

    n*

    i{ury poia lt

    to post

    mte

    gdc .dld Mala whid plovide r


    w

    dvD6

    ro

    ontDl

    'pleiptiv edg6ia',
    smiliv.
    tbat is

    l}.

    10

    pain,

    "Pain

    loir fd hoN

    dFidc.d

    toucb fo.

    15.10.

    timc,"

    to nonrhs,
    a

    (w@l[

    E}?!6ir.

    $e8ds

    sqt@,

    rn l

    F!c!ti@s,

    !e$ @o!d

    m. d.pih

    or

    Th@
    psy.hologr

    e
    lil.

    mton

    Fir

    As delbcd by

    tboualrs,

    sitivit,

    Rscb6

    tbrl

    hav

    ud rcmtly found

    p:in. this b lading ro

    Fli6l fel Fi!


    a way

    is

    nor

    !nd'

    rhlr molq D6rb of

    it

    rclF6iu. fd

    prin

    rhG

    e @ src

    ro

    ,,a

    U. Andi@ rsycrDbgi.d A$ocjrtion

    lbc.dft

    d$ng which a he,lth pref*ior{l

    d b.nlvio,.Hypffiis n

    rhc

    h.iELra.d srlc of

    septd B being Eue Ed cffd |he

    ed b.havior ofd iDdjvidual

    in v.,yinS

    dsr6 a@ding to

    ih hyp@tizcd jndjvidud lo

    phamtu-.

    pai! @trditioB lbit

    oul of

    qcil*io!

    clioq paddq d qpajDdrd p.tricilet dpdide ch.ns6

    lj/pdotic

    Miehinr

    j!

    bhin wh@

    This

    &y mqd rh.l ma}6

    ofh}!n6h. D-pd ldl ofhr?nosis oabt6

    .xFime spla

    cmlinS

    systqtr

    ro rhc

    1983)_

    sussqtibiliry, sEh rht th suagetions gi@


    bliefs habit pcceptions

    ld.M

    Mmory they @nclud.d

    Dvis,on of P3yclDlo8ical Ht?nosis is

    'whd

    rdos

    alt6 $.

    as@iatiobtwa

    . hci!)rtaed

    lirt bcrwd ndory ed

    "Io giE p6i! Liu6 b.forc

    ana Mgcry,

    qE

    of

    1hd is ! rhrioDship b.iw@ psiD ed mmory.

    foud nol@|.! c.lld ERKS-Ei!6 c.[dq sigral Eldd

    rb.

    b6D.l rh. B._L of

    dicd .nd

    @ndod

    Trjgdbst N@nlgia Hrlmsis j! a popdtul .linidl

    dhcdfo4 sine

    hlilDosk f.crivcly in lh.

    lool in

    nMgodt of

    hed.cl requiB norc rnm . siDptc !p,ptic!$@ of! hr?.otic indldi@ follow.d by
    $eg6tior orpdr o.trol. .HypGis mlr b. wi&ly in@,p@r.d irb a brelds

    psyc[oth@Flrc
    incorFral.d il

    qvqrjon' Borb6

    bc

    uheiy

    'llntrostu

    ind6ed rcc?tivity

    6d

    rbat

    ed

    6MioN*

    bpnotic

    Oain

    @iEol is

    n@s" Hilg.rd A Om.

    by oths psycboloAiBl

    ddonsirabl. powatul ddgBia jr

    puzling

    is

    thar ii is

    ldirg

    hypnorisl

    $id

    rhal

    ifs1o NSsdlid

    onjuction ir ncdiol

    hclp, ir witl

    b6&dE. HnD6is

    I psyclologic.l pb@omn

    mmd

    is

    p@plc by v.rbal

    (1980)

    in

    cetul

    @Dtrol of paiq

    uiq!.ly

    mt

    ait lly iDFnmr .djbc1 in ln. trsE @t ofchronic pain


    @e ofrh

    ch&&rdi2.d by Dutdly

    qpety fo diret

    the

    wha it is

    Edelsrcin (1981)

    oftrdtnqt.

    clted sbr. of

    to s!8asti@

    inv6tisalo$ hsv. st$lished

    achid.i

    powdtul p.n

    tu

    (1982)

    supdior lo rhal

    "ht!.o!is

    u.d

    wis.ly

    is s

    rtlhoueh n is

    hcldrchd', Tdbd (197t)

    hytmiis

    tu

    B.d ptuFty in

    s!..d tavay dd attdialc p.in dd djsnfon

    sgg6rio4 &d

    is

    which

    lowatutty

    @ b. ird!.cd h

    Gtared

    10

    the

    lim

    most

    i.dividut cqtrory

    fq inaginatiol HyFosi! with. &dsei. suggqij@ cmol Edue pdn. n&ueb


    sueSdtion th hypnotic lubj4t

    b@ ed sa s

    ac13

    "eli6

    rhai

    .trlnotic

    Dqrerion ofpli4 nth6 rhe by ,rduin8


    Bt?,btic

    paii hd lot p.jd nuch an666

    !.cd datgGia io ctinjc.l

    ro

    hr!@is. Mctzc_! rcFDn d

    did.ne Am @,rolt.d ,turti6

    thoir@dcdly effariv.

    for

    oy fom

    to

    pretd.

    of chftnic pain .,

    did6e

    (M.tar,

    Howcvd M.lzac,k & p.(ry 0 975) foud th.t .Arlnodc tainirg jroioctioM

    prcduced subslmtiat

    wha

    whn mr ht?notizd":

    1he

    do

    suggalion he

    pl.c.bo, llis is @rrDGi.t.

    th6e w6 @ Eli.bl.

    for hD'rosis being


    1980).

    otr

    pi$olt lpai.t

    cr@c & Rcyh6 0 9?2) irdicatc

    drug woutd

    nkh noE rho

    R6arcn6
    thai

    by

    principally by blocking

    Midy a . sdquilizine
    sitrDlio! is

    bc dd &d blind bur

    wcll within byTnosi!

    Expdibool nudi6
    suga6tio.

    the br?noric

    rlicfoftui4 sig.jfiMtly gqts lhe bio fcdbacl, Howaq,

    rliling

    insructiotu w@

    p6dLd,

    togellld with bio fedbacl

    fi.

    pain

    Eliefws signifcln{y g"ilr th& plduced

    by b$c linc plaNbo sessioE".

    (Melzact & wall, 1982).


    Thh $udy by M.lack &d Pqry (19t5)
    the

    bdtuor ofdrcrh ed !al.

    5u@sntl

    ws a s6 aeEt advd@, idietinS thrl

    pain nd.d th. @nlinine of ht?notic

    sngg6tiotu wirb fe.dbacl, In 1990 borc anddoi wdgivo to ht?noric augg6tioN in


    lh

    Iralndr

    ofpain w6

    mdifgr

    in publhh.d snr(li.s, 3uch

    s tho*

    refqrcd by Ciblon

    aBap(l9l).
    Ericl@n Heilay (1967) rcportd

    hatnals

    for pain.

    Aneth6i|,

    Thde

    tv.

    ..a

    veiery of

    wnlodox rda*.bty su@stul

    reclDique !s.d io @1 brpotic d5l8!sis a.)

    b.) Di@( Djninutio! of p.iA c,) Sd.ory Slbstitution, d.)

    Pair io eorbd, ls wlndahle body

    Dtpla.ddt of

    aE od e) D'sscilrion".

    A!6ibcds $8g6tios @ idue hdllwinlijo, of e6tb6i! th,t omb! Oc


    lo pai4

    be9n !o

    f-l

    ihar thc

    nMb, wirh m

    Dlnitttih:

    Dirc.r

    sv6

    b.

    n!d.

    i,You

    s ifdis@nfod
    |he

    inr4ity

    DgdiplioB

    p.tien i! 6abl.

    is

    Tbe P8timt is

    saion

    at all,

    ihc peiD but jun

    ..h

    rIft b dificutt to Mve

    eb.l,ow I'ad!.Iy

    i!@irgly

    well, wir! @ch

    njdt ey tht \dmdof

    s|.d r! l@rd

    th.

    iltwity

    rlE p.jn

    of rhe pain to

    S4ory Stbaitu on: HyprFric suee6lioro

    sNtio& .) sfue

    of

    3@$rio4 nol v6y

    pl@! fr qu}t.

    ws.l

    Ilc pld6t

    i,rolftlte bhing, @

    ro

    bElh you t le

    going away, suggolinr focu on rh. dininurio,

    b.

    reing dou volm dime bnghbB, mtine,

    advsreg6.

    fel !mbn6s,

    Ihis rabiiqe j! fd ,.d!cjrg s.ery p,ia . suggcnioD is

    @ntiru. 6joy feting

    oI pain. OD.
    for

    *peine

    ro

    de

    kmw

    high

    doh

    ldp@tuE .i..

    e dy ditr.he @ b.

    ee

    ro

    @L

    rcinrapa&do. of

    uoNciouly $pptd@red

    irchiDg or
    tbe

    nn.d

    of

    6lda*,

    by

    @rna

    su.i atLb.rc fetins trvc

    plir i. 3til $aq h

    q6

    p.ra1 for

    ryple

    is

    pill noi g{ rhe 66 a ir slill th@ e thlt

    mt iold

    rl[t

    lbF

    b.dic.l

    dis&Iinu.

    be

    (Su@tuly lsd vilh a peq

    6i.d

    oul wirh tbe followirg

    qhi.g noc &d

    n.sgire firgd

    belme tiny,

    whal

    thoNrld. of *cD 6!96 buirg.

    sgg6tioB,

    Fti@o sufraing Aom dyss0!6i! in

    cgjc

    feling tbai tou d6db. s hoi n6dl6 nrbbirg you @ begir,


    if tbe n.dl6

    dos nol

    lralndt

    Sasry $!6Ijtuiion @ b.

    he

    or

    i-serC

    l.gs.

    .tllty 6ough

    horc btwl od bDe4 alhosl

    e id6t'ES

    rhc

    to

    ..ttF

    sen,

    if ihey h!v.

    s@d@ yo! b.8in ro h!r,

    you leCll ml qtnty

    plsel

    bui

    PqhlF . w.lM r.liet'

    Dnrp&ar.rri TMfdina ofih.


    b

    enjcd oul. (Abddb.l p.jn

    tetDriqu. Ihar @

    inci!*

    js Dorc

    alBdy Dolic.d th.l p.in Dov6,

    novdot s@s
    anmd to Oat
    out of

    you dbdmd ed

    of!

    da s

    ir

    !@s

    to

    lrtil

    nodifetion h lhd ifpain @ choue

    jn

    ed

    you

    is

    bcsin

    h1r

    paiD is

    is

    imobil ..g. duriq sury

    "you Da, have

    b ,oria

    you

    dtat ttr

    inu !o

    tltr lr@ing

    o hFn6t opl,erion of

    losrior il @ atlo

    chanee ns

    dintuion

    &

    otiEly.', T.bbct 0 9?7).

    d*cib lh. sdll D.sj{ine

    pqeived hnt ihd

    giva

    thlt th! p.in ha etubop nov.d

    ,i$.drciar.. H}lroric slsasrim @ @l o disecjlrion


    pari.nr i! able ro

    b. stayi.g in you 1.ft bed,,. Thc gol is io cheg

    t*

    elinitrt

    eoit6

    !o

    patior who is cFjc.l stour hs o, ha

    slighrly

    you Day not Dotj@

    dprio@

    ofrh. body

    aeridg displs.dor ftr eg,

    so thai pain is

    ulthatly ruy

    orc

    ir &.t ouwddly spiatinS sdd dnsio..

    novodq

    d locu olpain
    such

    io b

    nm

    {iisuing rh& ljnpild. This b a valuble

    th. @nddae

    hypootic sbjUtica, e suge6rion for

    pain

    ro

    pain vjrhout

    $fraing Dh$'rtion

    or dwing

    riddd to dte dissociation nigit

    be

    &ob 0D p.in,

    ile

    ey lfletiv. jnvolvocnq,.the

    js

    u.tul

    wn.n Ibe p.ridt is

    sne painftl po*dw-fo, a p,ri6t

    wno is bed

    .tr is umc$dy
    fo, you b sr.y hq. h bd

    6eioB
    lov.ly

    of all ibe reutin that

    tut

    @us,I mndd ityou

    .nc|]rM r6dna oi

    lbrl .ll lh. nutje thirgs @

    ihe

    doft

    hach. You b.dy


    for yo'r bur

    yo! @ djoy wbalcva )!u lilc pitb nothirS

    ro

    fel6

    if you @ djoying s

    @.in

    ,ou nind

    boils you".

    h@ in b.4

    i, orda

    tal. yd fs awly dd

    Pon byForic auggGtion

    @ usd for qlantin8 fic afrd! hFroric alggBriotr @ al$ sivc I oe rhrr @ begin

    $886Ld

    dFt@

    that Dov@@q how

    whdffi

    d b.hvio. ce. .\yh6da I lift you ms yo! wdld di@vd

    rilty

    @mton bl. yor f.el

    th. pltidts lift! his

    tl c!.

    '

    this $ggsrion *ould

    tulcrio. of ontexi for

    .g. on

    nighi

    you necd io IEI reliaed fron ihh pait\


    tou hdve sld<trly aoticd

    b.giuirg

    th

    Ill.u

    ro

    fel

    6.i.

    skilh

    Most

    ro ihc

    (BaOd. 1982;
    A

    not

    pariol! @

    dw.topndl

    Fddreio

    &

    lsi

    ihrelehour lh

    d.y

    @te &dgqia,

    of &atg*ia, ova

    to

    @v..y follos ut

    ,5rhoeva

    al iD facl

    yo!

    nolt efletiv

    md

    6 l.m to lpply

    in@ingly gretd lagths

    of rin,,,

    set{hyrDosis is

    a resring

    ,oud

    for O patiots

    isport4r, paiials ned io know thar h.lp j!

    "B@stet' ssions de ale indicatd. ft is alqays wis. io try othd stratgy if

    wdkrrg rnd

    hft

    6 uniqu.ly $pdior

    in

    s.

    1977).

    l@
    is

    s,

    patjall ud toog taslin8 prir reticfis Ulbush

    l.m elfh$nosis quit crdily

    vnah

    tatiofs wiUirSr.s

    notivation for
    and

    rc1i.4 ud tb.l Eliefwin

    for oi:'ring ildepmda@ Sr rb.

    slf hrliosis.

    ar

    m.

    cls b. hatL

    lh*
    on is

    liB ln. ftativiiy oflh r@iing clidcid. ..Hr!@tic poio @ntrol

    to thai

    achid.d by othe psychotogicd m@s!" (Hil8erl & Omq

    r980).

    ''HtlnGis ha d$ Bbblished

    iwsstul @rd

    in p.rtiatric onology

    hriagdnt ofchdodalpy, clal.d naus4 dd vomjlinc bd prccedu.


    pajn". (Liosi A qlistin., 2OO3),

    senins in rhe
    rcratng

    'nF liility ofhran$is in for bum wods br6

    EFn.d 6 a \setul

    p6ychologicd

    inl!@tion

    lhar

    lple, oiod ndic.don", (waldd & K.pld,


    Hilg.d (1975) brv. dcsibed !

    bd

    st{di.d dd il

    b@r

    m. q6

    @ iugnh! dd ir

    l9?8).

    M dissi.do

    rhsry ofFir! 'h)4Dci5

    @ni@l l.radizriotr in cq.bril pltrc63ins", (Csb.l, l9E8).

    onftsl a nmbqof invdrigal6 hlv.qurjon d wh.rlE

    .ft.r bctod

    !a

    Moa

    H)Dnoric

    ind

    dd L&L 0 9E2)

    ir

    phm'@ he e

    r,t!t ofplac.lo" V.rdyct & H@gduitr (1990).

    "Chndra *bo $fra

    filr c.|e

    hrrc to b@, pdnftt

    Prrc.dG

    rhlr

    .ssiaLd eitb i@C@ dcgd ofFJlto*id diriw. Hypcis bs b@ sle.'stuIy


    !s.d

    ii

    ftd

    the

    i5

    dDlgd@t

    ofDain

    b aduttr bu

    is

    .l)mdyet oorgh@r.h did.@

    fuI well sndicd


    ro

    lefuad

    l5.ll. M6b.rtrD. MMaio digird.d i! th.


    Mtus,
    whicn

    hc

    va

    aid his

    bclie.d tb@ ws

    supDos.d

    p8jnl* s!4dy Fd!6

    irdu@

    (t

    l8th

    uod for

    6nri6

    6rry

    by

    J (2004).

    F@-

    psjchorlogic.t iUs,

    645)

    .tndndis tuitrs o.

    dp6ti&
    of th!

    rhnportic do.{.i!. or
    by rhc

    by orhd

    sy'ld!

    in p.in

    M.anq

    @rrol

    ed

    scidtifc cuicitiB

    q@is

    in whjch a

    io rhc

    virat @mpondr of

    with grat

    rlincd pn..iiiord

    ofa fo@, His rehniqB h&l

    pndiriond tyirS rh. lhe fobd.tion of

    lJ,r2. IDtlcrt. Visudjzrion is. r.cldqc 10.trer


    !

    hypooria'. Dev.

    v$ c.tt.d siDal hagl.ri6d,

    and

    bui achowt.dg.d his

    htlnoric st!r. in . parid

    body. lt is

    di!&ic populorios

    ef.dive i! Edlcing p.in i, surgicd op6stio4 ,oD. *d

    gFlr !!pql ed w@ delopd

    hw&

    ed antulion of hedacbel

    M@dim wd

    tu

    quit

    ln. claiG mmd

    h'siory of eal86ia

    quid qhjc!

    b b. Bponribt. fd .ll physi.d

    6ll*g!6 wfr

    ctnicd .bout

    e invjlibl.

    in

    rh. phFiotogy ofrhe

    imgay Fycioitc4y ! mepr thr

    .frqcy i! !I

    th. cutvlrd eB litc Elision. Ir

    is

    hrs

    ba

    $egerd

    us! visualialim stinulatc you

    lhat ihb techriquc which

    ssationr dtd yo! fel wh6


    you body 0o!rirg,

    R6dd6

    tbc

    w@il

    a wha onnD.red

    Ep.!d

    with

    niSblaine

    ollrw

    of the

    of rhc phyriql

    o. tou body, aiDcd d


    mys

    path

    sdmuti

    cbea*

    tm

    in facing

    .t

    rhe

    in@jrg

    d[t.

    thougt

    s $@panic

    qrdrt

    h@gry

    qln,n8 sqq . baclr a hill wjth fir@ dd

    ask.<t to

    flo*6

    thal

    ro

    insgirirs a

    phdd@n

    took by Br@r &

    pcfer.d cnes6 in rh. individut. patiorj hay b.

    to*".

    ydld. A lEeD wil

    rigcf s

    ldd |o. pnysiotosjcrt 6pons

    'rmie

    blood

    iiinuldd by vir!.tizir8

    lEling hdid ndby. Mcdi..j t@g,n rhi!

    $phjs:ridcd r@h w@ dd.lop.d


    h$ic

    ff

    sinilr El

    by

    se

    cslly dpdiadng enthiig wonddftl. Elmdc

    sga6t rhlt'tE@logic.l

    o.livity

    lmy

    you

    brain, "1o f@l th

    Fnd

    wbich

    ard

    095?). TtE

    inrm

    vj6u.ti* s vdy

    l.r<ts lo

    pl6d!

    prcdnc ! f..ting ofwcl

    Reercn6 bive sboM stres offd t i8g6 had!.he psi, dd it is inportdl lh.r
    tc.hnqu6 de Nd @ly

    slr6 r.Aoe
    DAI

    n@!ry

    tu done.

    arld in

    t.

    b.AminS of0t. aillcL,

    Ttis tehlique

    duing inn6 of rdiviry,

    e thd shon cimiting oflhc

    bc p?cticd aDy rime

    wt6

    quict

    tin.

    is

    dubg lI d!y, nly tE

    iorosibt..

    nE

    shodd he in@rFnrd in o.. daity rgD6. Smerim. p.tiaB


    @ siy@

    tuh a

    aids

    hid.d
    qmi&

    dots

    od wl1ch6 with dam e d[r wha rlE dh

    to rlo his

    d@is

    which nay b. iDas6y,

    ddi6 e

    d6isr.d

    s6

    dblobs wbft

    a dor or

    dbld

    trdhjns

    otu i. dlity

    they

    h.

    is

    qftis
    ro

    tifc

    Mll b. quickly

    $pFse

    q@is

    dses lh.

    p.rjal

    b nop doirg orhq rhi.gs ..d im.diarly

    taind lb. plrjors

    to

    adapliv. responsd which

    olho

    ard h.

    rehniqB

    !o do his

    ed .uog6jc hejn&

    beorne

    ave ed slf

    fd qmpl. patiats @

    s6

    dd duiDg

    ddh..

    .nd
    i3

    do his

    Th*

    Ggdai. rhe. nat


    rold !o

    thc day. so

    $ai

    llre
    d.y

    dors

    limc

    or
    hG

    Coadtrtion
    witn

    q@is

    b.gi! pith di@bErlnltic bdrhing. n q@is bcgis

    ftb lahniqe hmcs

    sbv ud d.? diaph4rnalic brdbs.

    '58l&cilg' .tf..i

    bffi6

    thal

    proF br.5lhing ha

    physiolos/ ot th. body ard

    @ndiIi6.d stiDulu! for clMtion." Swad pain tharist! hw.

    pain is @eposed of boIb

    smry, motivltioMl facrc

    dpd'@c. b link.d wi$ ud mdiat


    196; LaDlhal & Evdn.rq

    M.lz!.* &
    wlcthq @donal

    dF*io

    oD th

    "$e powdnll

    lbri

    rd", (B@hd,

    Ch.pmr4

    1956;

    1980).

    Wall ( 1965) hs
    or

    preposcd

    md rbal inrq8ity of thc p.in

    by dorionsl st

    Mtely

    p[ynd

    et.d thilpist Elsl dtow .cg.iivc dpEsio., ."!in

    b qus.d

    of rltcir amriotu." Th@

    dirly

    by

    popt6 oM

    6in!e!

    .vi.t o Il|.r .ligh lcwt, of

    Plir" &d StaDbrch @nclud.d (196) rh.l &t mdipDirtid

    rcduc ln. pai4 .xFihdtii p.in &d

    di.t

    thar

    ilc D.tud

    ro

    djdy uenor
    diay

    rdu6

    at$

    haw b@ .educcd by @g'ritiv.

    rontdFt ion rrNctudnS.


    Studi6 inv6rjeai.d tn

    'rektiv.

    ro a

    .ttrc!.f

    oftwo rrTs ofihagrD& sula$/

    pla.lo mntrel goup on 6ld pFsor pain &d nignin.

    star$r gtulp {6po6e sbup) wa hlind


    ofthir om rcstorB (.,g.

    nuc

    io

    inlgi,

    lqeE.k

    11l nDaginat

    pl6dl s6B

    misr.{i

    *nidr

    d Eld,lion, dc.p bqrhing). Ttr. orha imgin.l

    .b-algy 8tuup

    (srinulu gbrp)

    ddails, AX lhc

    sbj.dr w@ idtrud.d

    v6 irriucr.d ro in.gjn. 3@6 *irh ney niNbs


    to

    rb.n ft..rcgi6 ifth.y 3ae

    goirg lo hlE . h6deb. or w@ h.d ! had&!e, . he<t .he

    cmilg o!,

    or

    irdulgios h ncgativ. thoushts (qr$rDphirird_ T!. iDlgdy

    rotnot'

    w@

    supdd

    10

    ilc pl&.to onirol gmql'. Jud. M. Brem

    1.s.13. R.ttd, R.iki is


    in whjch

    ujv@rl dd8l,

    is

    fohd

    wft

    Od

    ctqty

    (2OO-,

    & &ci.Dr wisdob inluiriv. h.dine nodriity ed & .n

    chtueled, rhrcu8!

    of a riva, Reilj ,tnaDjng

    ln.y

    rhc

    uivasrt lif adgy",

    hed! ofa pncrjlioDd


    In l[G

    inro ihe body

    U$i systn of R.iki

    th

    sloDtlr@uly dd effonkssly t oNfd.d fim ont oM body

    healing ener8J is

    @thd org!.is,
    lhe ned! of ine

    lhrcugh 6e

    l@ivd.

    lorhiiS ofhD4r Th. stra8th ofth. as8y d.lqds @

    in giving RiLi

    Rfi". S.lfhelilg dagi6

    '\,.

    .*!r6.d

    @ mor

    rhougb rb.

    $d j$t

    w to let

    c,hmel, w. b@D

    Fesision ofReilj. M{ry

    clinjd rri.ls h.v. b@ oducrcd to lalidllc lhe he.ling

    Th@ @ fou positi@

    .ffds

    ofReild trotrnals.

    h.rd6.h. in R.ikj,

    l) Th. hsld ova ihc.y6 with tben pdrs or ih. forch.ld,


    2) Pl&ing lll. finga on lh. tsrplB ed tbc Flo5 o th. !pp.r sid. ofthc hdd.
    3) Covding lhc 6 wilh pd@ ir. @pping poditiou. S.lftrstual vould dtail
    @pping ih 4 wil} fn86 poi .d b ln. top ofrh hdd4)

    Pl.cjre Ih. hrnds @d th. bsd rh.

    Aditiomlr D@
    .rd bio ecgDatic sbjeld

    al6 ofEih

    tq@G.

    prcvm tnlt "R.iki af1:.r3 rn

    bcilC' Ro.lm c.

    pk6

    6.r&/, md dn5/

    a$ns

    orly b. Drinrain

    @ in th.

    wts b@e clhiql

    his bod on th. pariat with id@t to

    is

    Tnft

    ac

    nmbd

    rials hav.

    lifc

    6asi

    in

    hrhe

    hel ad r.b.loe Ocit

    of thap@ric iouch systds in pEctie. Th.

    $. Kri.gd'. llErFlric

    thar thd is

    6*ly

    th*

    F@n\ phlsi.rl, dorio.al, mot l ed spirio.l w.ll

    .lc.tricit , q Einst in od5| bs...l


    which flows

    mw hn ir\cii8ared $cb a disld n alirg

    Th.np.udc Totrctr. It b apu.poely dirccd hstin8 Dodality

    6.1d.

    hon polulaly ui.d


    TIF 1T

    All

    nct pr$bl@.

    R., (2010)-

    1,5.14,
    thr pndiotna

    is

    hald llal! bddsd. .!rl

    Iouch (1935), Rcili .nd Ptuic

    which is the spirir, $ut

    miv* rhdi6.

    being. !o and

    vlt@ m i.rlivid!.] is

    foh

    ar

    lh

    itrrye& Eagnetim,

    Livirs b.iras ptodlc.d

    qvil1mm1,

    uiiy ad

    Fe

    beljrg,

    wiIh

    This

    ao5|

    hondlesh @

    hiE$lt

    Bur ifhe is

    mi

    ed ifnis wirh6 ee b.ing $!pBs.d Ej@r.d &p6sc4 tr ifhe D..iilg r6hta@ tho

    rhft

    is no

    hmonn .i1h6latir8

    to

    Duc!

    d vqy

    lftdG

    ddsf,

    rh.

    .ih

    of eo.t

    of TI n

    to

    dol hmonyinten

    m @nclsie 5:ludi6

    tuy
    be a

    @ld

    rgy 6eld ed "lo

    on TT,

    patist

    lr

    ; si.d

    !r!.litj6d

    rcbalde

    ro

    ft@ ha

    n Fovids sPiritud etrG.r,


    th

    oagy tow i!

    6irs rh. h.,tls ofheld a . ft.u

    our by

    of the individual". Tlt@

    $n. Ej4tins it dhd $prdirnS it Howdarh@ c

    sion6 &d aredols $pponirg it hghly

    @n$ious intation of O

    6agid

    thc

    h.ding prc6s, Tndpltic Touch h ldnirisr.rcd

    i.

    to

    frcnirr.

    th.

    Wy

    lhc

    dn!.|

    leB

    s r.ssion whicn

    and

    twi!

    lhe

    ed nov6 rba sloely

    6dF

    rcldir&

    bDI

    bjs

    $bj61ivc

    whil TT b bcire don. on

    oth.B

    Thft ,&

    mddgo

    pq.l

    d hd hdds

    fa

    irch6 abo!.

    io
    bod,

    rhyihhiqly.

    ond

    qFi@e tDy

    SoG Ddiar
    noving

    ple

    of lh

    abour 20

    niN1e !.d l[. pdinr b. Btd to Ii. diu, eld.d i! . @ftd.U. Fsilion
    qui.t IX. FactitioF tbo

    to

    thd.

    sgdos

    ard fdlings Ift. nqr

    For Do$ p.opl. TT is gdrally

    aoiiod Epo6 lddilg

    hyF1bdis ..d

    .!d

    tcMIid

    to

    eln,c,

    ude{ie th. TT 4,po:b. Lifc

    to* ii4ly trough dd our of.h Fson's ffis| f.ld wha . F&n is
    unlellhy .nd in dirc Oc 0oe ofodo/ i! hirdor4 foti4 ohrnci.d ed dc D.lr.d
    mdgy

    o6F/

    TT

    rr..litio!6

    innuq@

    b.

    donc wirh no

    phtsiel bucb

    tne

    pr!.rnion6 @MioBly

    the

    pl.G

    0ow ro mov. towlrds

    rhe

    h6

    si6

    *lf

    in

    b a&ninjdad by

    of

    oe$i,

    md sh. nov6 ha h,nds io !

    re'v6

    od8y fld. Tlft

    d@@Ced

    beie

    ard

    dcc!

    r.ld.d feUns

    halh_ TT

    ling doM d

    h.dd klp

    in tE
    a

    sitting,

    !6at
    ey

    nolc of

    hela Egisla &y diffa6e jr lh! aEg/ now

    is foltow.d by a 16r

    Fiod

    in th. patidr. It

    wjin d inicndo. ro

    Fiod

    lnc n!,r!rEl

    BpoDd b $e cliats chansd ed rcbddcd


    a

    rhe body rh

    sad. rhylhbic notion

    this 161

    arld

    ! cdn .lat sble of bng

    mov@ol, lhd e sh. moB h6 h.nds, &on

    difad@ i! l!. noe

    whola*

    of 20

    Dirut6

    b. lsd in

    The

    ey

    il@pdiic

    lhe

    whicn is

    lalise DdtEiM i!

    aa$,,

    Ebrle

    dF bo<ty

    touch

    ryp. ofittnAs. Blt

    Drodu.e

    sd

    adjbcl

    ro

    otha irealndls bui it pdticul&ly givs pain Eliefin th

    child bird,

    ner

    in6.t61!uy !

    .nd

    $le

    of

    Em! Edad

    "s?ifc pdtdn

    nag$

    of

    b&r poi4 init'ble bowl sjrdrco. dd cr'mric nigni@ ll is

    dotioid &d $iritual

    Mmy slldi6 rcFor ihe


    Elaire ard

    plirfl

    slr@gth that

    .ffo.y oflidp.rnic

    ( 2000) .

    Bt@, rana.d c.,

    N$

    ,or le

    bu.h, Ani., ,ohn


    (

    1999). A

    lEdr

    ou !a.

    l'

    HakEq

    stldy fourd 3

    offi tra6)dl prldE d . !igni6@t i.o@. ir lmlifr.lion of

    fb.oblsrq Od.oSldt! &d L.oc't6 i! cdne. TT nry .fr.6 mmd

    eI!

    by

    sribuloringellFolfa i@", clowir.(200E).


    I.5.I5.GrclpTn npy. Grc(9 Th@py ir thdp.Dtic nod.lily b tlatjr8

    Fjr

    cfud preblds (dmpl.


    atldi(rid to p.i! Lilli!8 ddgs, tEufut dclreioa ed q6ivc d.?@da.y. GrcuF
    dd olhd F dFlogictl disordd. Hada.n. plriar f.e

    heling lhy nect w.*ry b8k ard @ irrad.d

    tueE

    iiol trad

    &rl

    tlisrs velally

    inra Flrhic, tusratior &d


    imponarl whjcl th. gDup

    flilw

    ovd whicn

    p.d@ls u$dly

    dddd o..
    Ir

    rc

    6td

    hclla lo

    letld nu't

    lbbld,

    orh6 grcl4'

    rafc

    thd

    inform N rbrt

    ie to

    poiru,

    olnidf, intdFon l .rd

    Dmb6, Pltidts aftiM. i. vqy

    in0Me.

    th. grerp Gl.rionship wirh !


    not

    Ftidi! rcntild. th.ir

    @gninrF oEed

    hada oueht !o qen $m.

    6a?py rith

    Liratw

    lain

    ..b.! wirh

    fron ortside aeals sd


    of

    pain gDup8

    $.

    lhcn

    to hclp

    is

    r.hd

    'l|c6s

    pNiv. .ftitud. od @hpl.r.ly

    elinglk!

    lDd

    .8ol! ofchdg..

    tuUre

    rhi!

    lowdt*

    tbft m sa clitriqly Fo@ |q!c ftr ocidai!8

    6 a reli.bl. trafnat inlNorioDr


    et0146

    lovide r Eo.r

    rdt a nMbd

    Hadach. md Chrcnj. pait

    willins to b6h dynmic

    h.lp ih@

    ro

    dmnic w

    ofpadots !t

    @ tin..

    of

    rbapolic le!rc., alowilg

    lt

    Prin srD|9s helps to rlduc.

    saE of iiobri@ dd diadio! tld .botdotnar

    whch h fobd in 3ll hed!.h. dd psn p.1idt, ihey ihinl ed beliwe "l

    6d

    suspicioN toweft

    olh6

    h.bl4, lrd

    bloils o$@

    @d

    for

    (mtlntnid)

    lan

    in lhen

    b6i3, Pltidts nay

    wdl

    pas

    .j *ii.n

    Bid f.cdbet

    & otarMiry

    to

    nilo

    intdacting wiih

    .6

    h3

    &fciq

    otb6

    Plin Crcl+ provid.

    iaigbt! inlo then tbo!8hrx

    Th. aout

    lMh<
    G

    wbo is

    @t d@.

    wont

    fs

    lhc

    E.id.d

    Cmup

    itr

    dtat

    of rh.it

    .d bd8id

    in thn

    taha|s i! @. 10
    is

    3utuir8,.

    ! difffi1 di$mslic vi.*Toinl

    he

    iD thc

    !d@

    he

    sid

    @ ot6q* hs sttong

    @pirs sLiI. &d hn

    .r&rion

    rh

    to

    !:mb6

    mc.pt

    of

    io 6rd ooa

    uivddiry n nrl6

    d.pl*.d .!d wjlh&.M

    b@w

    th.y

    thcy

    ircidl

    htE alevo

    EfaqE

    !bilti6.

    i@t

    thrt |[?y

    goup3

    rh. paljdt

    awd

    or[(

    q gorg

    thai ihcy

    talt abou rhn

    rot b.ing jdgpd.

    pl@ fo gjvbg infoddio di3dfming hyths, foltld

    @otiord inlolclion duing @.vasati@ &d redu.tion in th.


    is ako

    thflpisi

    the

    dd .le prDvidd sugcelli@ to olha.

    nis.., .!d

    ald thoughb nely

    tt6.py

    fedback

    a of'p!tutujty ph@ patidtd @ o$.nia rld ftiE

    lonelr.

    is .

    Ddba! vilh d.dibl.

    lNial @nrdt ed th@

    hd ld,ptiE

    .l$ li@ot6

    Gdp thdpy
    chag6

    in thc

    d$ e oppoduity

    ot ofr

    t!tt@i!B.

    lh. b.Srvior ofrh. hadd.h rrd p.in prli.nl

    ldlplive ad

    Pnr erculs

    diffi.tnti6 tld

    @ @r foud ildid.hal

    P.in Croups p@idc th. thdpisr pith


    8ds

    of@nbol ofbcirg dery and

    fron ihdpisr or lh. Fmi3. lnrt

    .afut rtDrirr.

    who sinply

    oDt

    (M

    Plin rroups previde thc paiiors ed srclp

    one

    w ofi aFsEI

    orh6 b@@ ofDy Fin" $dnb!.h 09?4) mtcd lhd 6is

    slidsti@" includ.d felira ofb.iDg

    m difrdd'r

    do@ eh..! p.ti@l! @ toudt

    ro

    uoul

    of nD..

    intoidi@d slills. Ald

    SyDploN @ringot

    6.dior

    offa rtbcl.d ed

    is

    roughr

    dd *rts of

    tm

    thd ref@ to

    @muic,ring wilh othm.

    Medic.lT6hot
    1J.16, Rrdio Fr.q&!ct. R dio

    cl)m1 (AC), tlErc

    is a

    filq!tuA

    of

    slmiol

    bodi6 lilc Dul.@,

    f@ p!i!

    h.ad.ache &d

    rmi!,I.

    say

    Save

    rbd

    b6ck rheir

    Prdio A.qMcy

    c.lled Fdio frlqDacy,

    liv.r "iD

    3d

    ddcdnior

    rhat

    Fr4hct ThmoMlosis
    eho

    ihtu

    lehnolos ha

    of

    Cr6

    Bed

    i! cdi@e6ic hadlan6

    @i.o8hic [ed!ch.!, (Slohdi,

    show

    *il!

    rhe

    Kohtad

    lo th. rpine in

    tu

    neld

    posili@cd

    dt frc.tjoinls,

    Cl!@ic

    Cdio8aic llad&h.". Jb& Jug

    N&orony. isdio Fi.qEcy N@tony isa

    b Fodu@ chdes u

    tl!o!C!

    and

    thc atjr

    dain

    inl6d

    thc

    ad Dwla

    th. 6dio frcquocy

    Third @ipirrl-n@.otmy tars.ts th.


    body

    &

    ".6cacy ofRrdioli.quacy C@iel

    pro.dw vqy higl y spllistior.d ald advec.d whid @Bi5l ofrb. alttli..rion

    po..dw . pr!b.

    I!

    (2007).

    R.dio Ft qu.lcy

    aein.dly hrg.t d el..lricd

    nrlio

    s sirSlc visir,

    Howdd olh6 snldi6

    lJ.l?.

    ro

    oDditio ofnigr.ir. DodoB

    Juo. Do.8. Sue, dd Htus,

    gig.hqtz It is

    which

    hdition l hotneir, S@c TMG ed

    ZyS.Fphysl Nmtony i! P.ti6ls


    ,

    trg! I

    Bpo.d

    p@cdw k probably not bd.ficial in


    HcldI, 2001),

    3 kilohdt2 to 300

    in ln.

    .ltaftting

    p6s:bly @il r.dio &Equ@cy ndi.ti@

    rhal do nol

    th. mod p6intu

    qu.l4, ed

    hir'!in. sFidin u. a!rccde


    b

    is

    eldrmlrrclic ndi.lr@

    c@nine4 *lich tug ton

    signals d

    ilqhcy

    nde nrdio!.
    lo tb.

    wv.. injw

    r'relr.d
    lhe

    pdiph6.l a@s oflh.

    lhe.wc rcgamrc aie 3on tirc,

    of

    ln this

    ffi6 rql

    Ainal

    nd. m1

    rd6, 6 thc cll

    but th. relielis pr.vid.d

    n.velbld

    ihe pdiod!

    ofEli.fobhiftd

    qtqtsirc ed siSErfdq licf@ b.

    $ught dgrin by lhc rcpaition ofih. troc.duc. This pmcd@ do6 ml


    of pah

    n is only

    howqa

    r.quird

    . pdliltiv pbdm ! b.itd


    al

    F6al

    lh@

    is

    lrEillff

    m otba fom of

    witl

    .dd6

    long lasting

    Ee.e6l fd

    lh.

    eN.

    eliefis

    this fom ofhadacr'..

    E:pqimdral liudiB h.!. irdiotcd $.1 rcfdtEd plb frm ihc c2-c3 zygrFplysi@l

    joi

    is

    in lh. h.!d,

    Feiv.d

    Clitriol srudid h.rc 3hom lh.l lhir fon ofned.cle

    Mipid ndc,

    b. relided by ucslh.tizing th 3rd

    zyg.pophtsal joint n.@luny h4 shoM


    wiln c!'jonic

    10

    Studid show ln.t "RF

    prcvide subsla

    i.l

    P8h

    wicd

    Eli.f il pdiols

    cdi@gaic hdd..$. wt6 @tuUy *lded Kol@", ,

    r.5.18.

    (2007)-

    Nd W.rNdm TdlloLar. Moddd *idliit hlE fo'.a

    citrerdinary n.dic.l .pplicatio.r, tiny'heo docloi'org4i@ lrt t tiiv.l thrcuel the


    body

    hbe

    @v6g@e
    @gritiv

    Mmy

    .M

    intof|A (w.[ a?)

    holald

    hav.

    inv*t

    D.jd d.v.lolhats

    io dclivd
    d in

    initiativ6

    to

    in

    n.Wlogicd tcdDologre.

    ddclop mtrials od

    dei6

    tl tub

    .dB

    TElgiIoU EleFicll Nm6 Sdmd.rio! Ttreue@u


    srihul.tid h6

    h6

    uscd for

    the

    wiihoul

    @i.Cly . $f. pDdE

    T.E,N.S. is

    !r!d ir .ll

    Trsc eeu!

    cfuody u.d

    .l61rical

    nfl.

    et

    ot rh.

    19?0

    Pdi6l to .cdu*

    side etr

    $is
    his

    i5 a

    6 ta pain

    cl.

    lrd .clE ed

    Linds ofprin

    drrm.ly relilblc. pncti..i od .felivc ir


    slidron.

    rclj.f ftr pdn, si.a

    $frc

    nonjnvsiv. l.hdiq@ whih allo*

    bosr

    dla@ b4lnbdioni.S'NBC

    $d! (Mnis, 2004).

    15.19.

    thjs

    to

    r.chmloF/, nddd with bio tchmloSy inforndion r.dftloey tnd

    *i6a ptuiiG

    6uii6

    Glc.i.icd

    c@putcr

    is a

    th. Eoitnor of

    relDiqu. whi6 is

    cdi@l had&l'6

    slinuhtion CrENS)

    cEolly

    foms of ldo&als6ir Sdqal re?ons of ii5

    is on

    ofth

    .fracy 4ist

    Litrahpropos

    rh.6{lnis

    Pr6]Taltic inbaidoi in

    by whi.h

    thc

    IINS ptldwc$ @rmodtiLtion n rb.

    ddsd hon oI $. lpin l @rd

    a*!ph.lia, .id dyndphia)

    Endos@u pair @!tt!l (vi! ddorphiN,

    Drel innibirid

    which b

    Nd6

    abrcmally
    inpur,

    letrdB

    plo.d

    qcit

    nd.

    Sihkii, Bolding

    (201Cr.

    stinulation. (oNs) For h..d.chc ft cnid out with

    $b.!t{ously inpl6t64

    d aHon6 dd

    ch61

    afldt

    R6r@tion of

    o@jiial

    of

    ehich oBilt of

    is @tu*rcd io th.

    bdlry

    snelior

    th8l is Fsiriorcd in

    drdsion larh whjch

    .ft$ 6 borh @ipird nd6-

    lh.

    linld lojoin

    ftj3 ichniqE ne

    b6 u.d with

    @Bid6.bL ba.fit h H@i@i! CodiM (HC). (BM!, w.tliN, 2008).

    Vrgud.Stird.riou, V.gEa*nidd.ti@r.dEtet.rory
    nicEine ed ci6t6 Lad!'hc, vigs tF6 stimllri@ hB a idtdl!tr1 olc ir
    1510.

    tredng

    eft

    rcFa(rdy hanlach6 fd

    inn r.blc d@tric hiSniE od cluss

    h&d&hrs, (Moukopl, 2005).

    ErFinmi Eilg tal


    lo rcdue the

    ond,
    is

    tution

    which is

    of p6in

    odcied

    tiDc btiin

    in.gi!& ddorur.td Ort "individuds

    !y oeolliry th. lctivity

    to th.

    !@ involv.d i.

    pcsihle tur p6ple lo dldiatc pain ortudr n

    pain

    of lh.

    l@trd

    urrl sLritr cingdaled

    p@ssin&

    In

    th6ry t!@foE'\l

    f..dbrck, wilhout Drues",

    (Rodaick, ciltey & Kilta 200?).


    sub Occipitd

    rtoncd in

    Ndm Slinul.tioN Signiner ed @siddible adve@s

    rem $inuhrid tehliqu* fd ncdic.lly inhciabl.

    dierd6. "Tso pmc.dG hiv. prcgB.d


    oftbe

    sdl6

    @oprlrl

    nd.

    in

    chftnic nad,che

    clitricil sttin$ sub@ipii.l stinulalioo

    ald h)4Fihaldic d..? b6ir gtjEul.tiotr in dds

    c!rcnicr.d+}!. sy !obc" (Bu4

    2@E)

    have

    6isrd

    StlDlLdd, A! impbnul|.

    1.511. Spb.l Cord


    .?idursl lad for 3pin l

    a@rdirg

    ro

    .dd 3tihul.tioi d$ ldDM s do6.l

    cord 3timuldion.

    lcD9-CM, Spirsl @ttl $inul.tion (SCS), .ls LmM s &a.l @lu@

    fd r.liai!8 .bqic, !.l@ p.in tftush clc.lidl

    sribuhrioD, b . prcccd@

    stibulti@ of tbc Aind @il. lt

    ne

    stimuhtior eyst@ imludilg

    dE 3pin. ro

    inrdul p.jr

    tu

    @mplish.d by ibplelitg & .l4totric lribul.lot

    3i8r.l5 to rhc bnin.

    r'dtuc i. th! d6dopD@$

    oftb.

    Fi! b3. in0@cd 3iru.ru.{Fi6c Eehda dld


    Itrplmt d donq for 3titul.tior Tii! itulda two d.vi; Spind qd sinult!@ ..d

    ad6lelir8

    dep

    t6ir ltiDuhnor

    Mar&is
    rb.

    of noslbiolog/ of

    Slibulnion of o. lpie w3 p.i! wi!

    of tb. !Di!.|

    of

    El.G wba

    n tu

    ro

    lsl Finirl |B

    a.ti 'A

    wlta Du&j. ftib

    ro

    Th. LigSpr poirr

    of

    Ei8gr. poilt is r

    !.1q. Thc

    twirc! insl@t rily wha toEh.d

    3Pi!d

    of norioA ud

    rh dton
    *i&ly

    cFld

    ial irigga

    sd

    dgb! rcPy b.!d ofou&|.

    tlx

    or

    bc

    f.ll 6dd llc 5Li! ud

    uy

    (.dld. jDP 3i9)."

    m .88nvlr.

    *.d6a

    bi8hly

    .nd

    hol

    is

    ottl @y Fvidd.lict

    m!*lc Nmd nu!.lc @|t.rct!

    lDr ona

    th.

    s!ftuding

    wbichirp.in f.ltinelbaponof6.body.

    is

    6.

    1512. Trl!8.FFbt bj..do!t. O?I) Tri88a Fint iljldion E

    duetd dlvdoFar

    mg.

    @tt!l

    tt rtiDd.tlD of r hg. nmb6 of .troat tba ir


    dtl Dd llc qla n .b&io of Fi! tdif &d edsdir

    tut dtirdy udoc@d. Etc.tic .iiDuLli@

    fm!

    G.L

    rhtl @dd bc ..iiv.Ld

    ddd @lEM

    Finily

    'w6

    Ov6rio. dy

    dd lad

    to

    t f6.d Dd!

    lad to Sq

    tisc,l@ or

    ffi61

    lelniq!. lh.i

    my indag,

    Firt inj.dion it . w.ll !@g!iz.d

    ulcd in Mu!.I. Ta.ion

    rr&is *nb riglr poirt

    !.liEtiotr

    myofd.id Ei!g6 poiri

    is

    r!*,

    ! ht?qirir.bl.

    Had!.b.

    fol

    bolins

    thc sycl. ofwhicn

    sd 3tiffitg ofolha trggd Poitl! 'A

    los

    wilhit . tlut bed

    oflt l.id hscl. lhli

    histologically @nted lege

    !!slar@

    qMtiti6 ofpl.l.lc& rrd EAt cd\ 6n d@6il5 abn@.I


    qudlt

    lnd nilo.hoid.ia, s@E

    'tng8d

    poinis

    .ld mu@Flysa4ldidc d.?o6it3."

    ds

    nalc

    l@i of ov@diw

    lrd impoit

    cir.ul.tioi lh.y

    tmds poini3 wiihi! palp$l. tigl! repy or Dodula beds ofnus.l ir sPm" Fd it!

    hqhboi
    0.5%

    s 24

    !rl!g .eedl is itudt.d dirccdy into lhe

    blpiv@ilc b irj.dd

    incg*b

    wil

    lusdz.d
    .

    fd

    by

    tu

    not

    1ddng. T!

    achid.d .nd b

    O.ir etfiqcy in

    ir

    U. D.i!

    ba

    |}e

    injetim b.y

    tElnals

    they

    bc FD.5t!d

    b.y b.

    s.

    lnd

    oiho

    b. iiLniif.d.

    ro

    I d6tjon.l pr@de such 3 n@B


    u$d

    d$. of I nl or

    tadds.td

    inplt d", biti.Iylh.

    objli!. .leiopnysiologici

    dlrs howdd if rlif i!

    bna

    will follow wilh Crat rdicfin Dlin &d hadacba T[b .licfh.s

    probld whi.h mds

    lmg

    ed

    hucle '"Ih. pariFl will @cl with 3n involuta.y

    into th

    juporgruDt wbd th.irigSdpoi

    spot

    tstddt

    tslnar

    of

    blEL tnd tiges toid itj6rj@! h.w

    disn6. t.!|*

    of had&bc

    had..b6. Molwa $d!

    is

    n howdq lild.

    dr|

    for

    widcly .ceplcd

    {g:a6r do.g hada.he sp@.lisl 3 to th. oPtinal tenniqrE of i4cdioA 0?. od


    th dorcs

    ofii.

    local &.stberic used".

    Ilsb.ptt

    (2010).

    1.5,23. Cryo.urolysis: o@ipil.l dyoncuolFis is

    ud

    ro

    oursid.

    tdt rd. tu

    satl (rc lusd

    rbm

    speifc ndo Tl speifc

    nnq

    gadLd

    llc slin l @l!m .nd stul) dE

    whicb is

    il.

    whicb is

    On@ ih.

    nitmu oxid.

    ro

    to

    by

    Fiphanl

    trcdlc)

    idoti6.d .td

    pbb. is posiliond of prepd

    ! tdp@tu6 bctwd

    intefl@tional procdw

    nffi G*dhid c l6!t d

    lh. @t|dition of@ipirll fturdgi& A pob.

    mll
    i6

    -50

    mcriqiously md @etuliy pl.c.d Dqt ro


    thc

    pl.@a!

    od

    -?0

    ih. pob. is ued to $indaic ih.


    th tip of th pmb is

    'C C58 ald

    -94

    'F) to

    aol.d wilh

    $. ndc

    in

    sc b4t lowotds ro ufma Nm.L is


    'l
    onpddjvlt ! sfc precld@ rX@ & hadly dy si& .ffets &d ullc$r odioN
    ie

    bdt. Th.

    n.rc

    i3 tunctioN ard

    ft

    ru!.

    of

    nd.

    tin6

    Sonc

    socn6s in ihe

    rw. nly conti@e

    for

    ! @ql. ofdrys d

    ftilw

    turcrior 6Dpli@1ion.

    " O@ipiral

    .es.d b, Fiph@l

    dtq.elysis

    |rct

    is a

    prcc.duc which is

    u.d

    tF.t

    to

    .d.

    p.in

    gdd.ny du! b tb. @rdili@ @ipiLl roidri.". (WiUi@

    2010),

    Phy.lo0.npy.

    1.5.2a.

    mipdalv.

    thanpy brv.

    rcle

    i! bed&b. rldudion",

    JeIM & OIel. 20ol), Moy tee'ots whidt

    d. si&abl. dida@ s

    10

    il! .6cacy

    hadlchc, ln this nod.lity low

    dmis dn
    (r!I & St e4 20Ol; ToEli

    PhFiothdlpy Dd ths.pdtic

    in rh.

    spporr.d by didene, clircpnctic

    trsfidt

    of Ttuion

    for tQbriqc 6 mid

    renurcle
    v.lE

    pdt

    Ms$8e

    .nd

    ard vcry

    in

    nilmlou!

    ways.

    .) Bbcrs

    the

    cdi@g6ic

    thd.py, M6.ge ircluding

    Tngg6 point El.aser d.p h6r th6.py Dobili2ltioD, sEclliDg


    usd.

    iype md

    ultnsu4

    tlmi3sion

    Fldiotr a

    orpain. b)

    tclu6

    trcbrbl, h$ . FFlologiql f..br. Mas$g. ha g@t dErFrlic

    mrhi.s sd Eluins. Evs Encrovd

    (200t6),

    Kl.ppa 099), frcud &

    s.hwanz (2000),

    lJls.
    brqthirg

    pe

    EyF.bld. O!tg@ Thd.pt, ll)Fndic orygd thraly iopli6r6


    oxyg6 b

    pcsEz.d mD, Oxyg6 th@ty k N.d

    ro

    lrei

    dMpsior sicli6s,

    infetiols, osls

    woutdr whicb dorl nal

    b@e ofcqtlir d6i6 lit. dirha6 d rrdiadd injlry.

    lnlirtb dd blbbl6

    of ai. in the blood, atd

    lrEm tu ino6d to dre iiG


    hi8!d rhm nomol pEsN, Urd6 in@.d pr@ue lhc ls$ @ draw togclhd tbrc.
    r(m,

    ln . ht?sndic ory86 thaipy

    tin6 mrc oxygo thd


    'lxygo-rich
    laclon ed

    sta ells

    @ciddrd

    lot

    is

    Fsibl.

    blood

    !r

    mm.l

    stioullre th.

    that dd hcrline".

    cffedivc in he<t c[e

    lh. tir

    sir

    !6sft.

    body which

    rel.e $bstare

    El*via (2004)- HlTdbdic

    nscq

    call.d gml1h

    orygBn

    ll4py

    nldy wa @nd!cLd by Eft.d.ll",

    is

    (Lyd@,

    Held,

    whil6, Brub.kll & slona,

    ditrdc

    in thc

    hyp.ttdi.

    oxyepn ard

    2004). The

    6dts

    @n!!l arcups ed

    signif@r pr!9hyl.dic cr..t i! DicniE &d

    dc

    tbe

    do not

    pd ey
    et

    prol@l do6

    show a

    ful inO@6 thc lqcl of ddoth.li@

    A!.lcsir 'Tt!|mtuion of tair si9.l3 .vok.d by


    tiss &nagc leds to sositiz{ri@of thc Fnphdl ed 6ttd p6in palllw.y!, Pc
    1,5.26. lcDprivc

    @ptiEoda6i!k.rr..h@rlbdisiiili .db.fwth.$r8i6lpd.d@inoddlo
    ..dw

    lhtu

    @itizrtD

    dpdv. &!k6i6 ha

    Owin8b lni!

    ih!

    Fl6li.l

    Fd.<tiw'.ff.d

    idtiltd !ffd $4cry," Jdgln B. D. &


    The

    ro

    ed prcvide

    tb. 5pi!.1 @d dd

    A@rdin8
    it

    Sta

    prduc s

    ro

    Whe

    th?y

    wolf (1983) this scir.iion

    in@sd sffittvity thst

    betw6 pair ed n@ry "hlo.tjna

    p.j! fc ho6

    sciiiv.

    pain

    w dpdioc.d. Aiiq

    to lbe

    to

    io

    h.l

    ro

    @tol

    lhqn.

    sursiy, ioolh

    Nru

    qci!. ells iMhtd

    i5 a

    no

    for

    bx.

    Th@

    nmdy

    'aold

    &

    t D@n pdr

    wilh DreirS

    d'in o$autd

    sd .lwi.lids

    ts lhAl

    tqtDot

    esiation ofpai, ..d Doory

    io posi

    hjuy paini

    aociaiions

    @ piovid. a nd b4it for

    ft.rin8 p.j.". H. diMvdd dEt prin 6116, th. rGrcN sydd


    of it

    pto

    M,, (2001).

    $Eq.!iic trg.ts

    td!.

    tL@i".tli* t "td'

    Gfretiv. tb.tr ! sibta &dg6ic

    n.w di!@vdi6 .hou rehtioBhip .rd

    aery inld6tinS

    sig.ds

    bN

    ro bc

    bc

    in .

    mclud.d

    $y
    is

    th.t

    n.t6

    r.+oBibl. fd

    pan
    the

    d ey wlm4 t!.t trke & Na, !@

    ro!.h for soD. hn.

    Resmh6

    fouDd

    ml6d6

    cdl.d ERKS, (Exba @lluld sisnrlichltd

    TLy crrry sign.lt tom dr tEfae of lb

    tuldio

    .!rt by ch@gine

    ntuy

    of

    4ll

    in

    tbe

    tb. 3pi$l

    s.y CsB

    6d.

    to th.

    Affi

    orEd

    otr

    in lhcn

    Dd off

    kiM6).

    nebi, ct48j!8 l[. 4I5

    d ER(

    ct&8c rbc

    welfsd

    RcRols, (2009). Fy b

    show

    dd nmory, ifyou h.v. .bdoninal surS!ry you

    a!6th6i.. howa.r, th. iftision ofski!

    F.

    t nv.l via
    long

    im

    ro ERK'S in

    cnegd

    !o

    t*.

    up

    prolongins tltc pait

    $itahag

    lh.

    opa

    tbe

    w,3

    ndoty

    for

    Nv.l

    of

    siltifi@{y

    drcs

    ed $nds.

    ler

    nG

    post

    6.!rch6 DlN.

    TIF

    believe wc

    lN.

    foutd ihc

    6c

    rhal

    10

    do not

    hot ot

    wer

    telort d rhd prmplive

    (1998)

    opdaiiv. Plin duing hospitdiatio. ald lolg ona

    *!y adoidstriry ii b.for. ndE ih& &n6


    qu.stiotu lDv ERK

    tsic

    Fldn6

    rhd

    RMlly Bc!rchd
    rw

    Id

    e[t',

    injuiy od this

    Srves

    wm

    of pdr, $ai

    cidicrlly noxiou. Popl.

    in66e qcitlbiut,

    vho c!@1

    fel

    nutlarioD od r.due life

    nave

    ptodud Prin'\re

    wound

    .d

    ir !

    rcgjon

    in the

    d isieht dd uddrltdj!8

    oxysa wilb citrs .l4trbtu,

    upon

    qlled

    lo.n4d @clhins

    yoD

    lh! 8od is !o

    fd xdple

    .wid

    han disd*

    foud e dztDc

    Tl.npy- Odn.

    !.i

    lhis tind of Pain

    s!6i
    lnjn

    (O3) b

    ut word Oron cohcs

    hdc

    thtl

    oI lhc br.!n

    ofln. bnin dl.d lb. urdid cilrdat.d

    1J.27, Oror.

    pmaire

    (Wolf, 1985) The

    .l@nic p!in. ZhlP s.d @ll@g* (2010) fourd dis.d lry.l oflhe
    M zta

    ndif*tiiot of

    lill6 b.for t ti6l f..l Fin

    Fin, To Sivc !di.

    to tum ofr, lhe

    e@

    .!d

    duina lh sEg!ry thlt oDcluioD

    @?tm d tpind @.d cclk thd ih@

    ir dlsralon@i. sufla

    shon

    thde .ihsge c.lls rdain lbeit

    NMDA & its k.y to @nt olling th. scil.bilig ofrR

    rsdchd

    1o

    rbnt

    bEin wl@ sositior of

    Pon opaltive pain is 3

    su.d

    di$hdgp. Morphin. n mp bonc Ds.d lhk

    lardor

    b@!u. yo! @ undq

    pain

    and in lh

    ddth6!,

    nor.ft6'prmPtiv. urlg6ia'- Al& Got$h.!r


    maleBia

    linl brtq@ pait

    ell3 of dE 3Di!d od- nF ER('s lad

    pr! th

    w.ys ro

    lcl

    su$lc rtodw6 hu8. distB sirlrls,

    snd

    aw.k. and th.

    hsinralio
    on

    do noi

    elts in ih. spin l @d,

    f.ll. wlrd you 8ct

    pain is

    r.

    ho{ ERK'S pbvid.

    dIs
    CEt

    maleim

    for

    6zlm. rml.in

    alotroPic dd

    fton !

    pait lat 6ns

    Ki'e

    oflh. injurd mie

    ooriz.d fom of
    wotd

    nding

    to "1o

    smdl

    in

    n is

    hrrlly bneficiil in mmy nedicd disodd

    cpinio.y di$d6 lrc

    Disdd).

    Dr. ono

    sc&dtully

    wlilltr

    fow w.y3 to

    ',r-i;ds

    insmstios
    which

    sd ortga
    dt6ndly

    '
    v*l

    is

    having

    ndf pint

    mcdical

    ertigblbag

    fm

    th. P.ti6l .!d .dding

    .! i Mial ooa

    mod lh.

    of Oeiard oliv. or

    ba

    @d

    D,.098a)-

    and

    | 080

    cmfonlbly

    gG .w.y. "Thft
    ir sfe

    foud

    st

    mi@

    or

    baecine

    tb

    *in.

    d)

    O@.

    is

    sl$ u!.d

    ruflowd oil

    to bc both

    Obn it .Pplid o.e

    @n@tl!m turitrs Aon


    @ b. nfely

    b) Rd_t

    tm hdt &d bl@d

    6@

    obic bni frq ir a

    eibd bt ih. b.dy-

    iht

    is

    phm dilutd to

    sf. ad .tretilc

    tvi i!.ilv d FhlP o! .lrdare

    gds

    en

    ollLe Uood

    Di8Eire hed&h6. Allhough O&rc ad hvdioSa pdxid.

    hiSlly toxi.. n!y hav

    ltrl'

    Ob..

    om.

    d ble ttat d A mixnftof od.

    dis.e pIhutry dilag inf..tiou djsa$ di.btl6

    ihdFutic

    pltidt

    c)

    Bio{ndadre thd.pi6 bav. incdiblc rugc ofappli.rtiot

    adits ro

    tu. previns

    O-trq !) Auto hdolneltv

    t@

    of blood

    oxygd is adninisla.d

    Dor.

    6s.

    pmp.d lo lb. blg .td lbetb.d $rcuri

    in th

    lFph rod6

    oar

    0r

    bu1

    Pdnonay

    i! M.djcilc

    lh. bl@d $d l!@ injeiing lb. bl@d b!.1 to lb.

    ro

    ozone and

    bvolvs

    COPD (Crdio

    lh. NobL Ptiz

    bofcirl i!

    iNmald dicli 6t!il ffiovjlg


    dd orygo ss

    90

    in l93l

    thal ozotr. is lrisHy

    Thft

    snnd dd

    breochid

    lik h.rd.chs mdj,

    davs

    ir

    gal qwdrv a

    @linu.d till fi. prebld

    e nsy rePorb abod sl@siil tatnot of c4.q sbowirS lnrt

    loriC'. Midd,

    Ode ltdpy

    ns h@

    hcdla.ho &d p!in", (Fontain

    Autol@othdPy

    is

    S., Kiog M.,

    dd Bu$rdt. B 095?) &


    '

    tqffiad.d

    to

    tqt IMv

    @tditio6

    M64l

    lit.

    , 1879).

    . t chniqE in which

    btood is

    tlkd

    tftueh a veit' En.d

    wi$ obrc gls ard ln@ ini*Ld ha.L Wl|r dichd widr oaE n 5 bn u.d in m.
    E4un@i of

    osldtlritis

    ald

    tnm.toid lntuils

    ft@ E
    lmFF thll

    lheapi6 whrch ncd

    rdDFrru6

    Mi8r!i..

    10

    thc aldtr

    To!i..

    Botulnrb

    and

    is FodDcld by

    haw th. ot'p6ile

    b. incorpoELil

    rMu*uld ju.;tid

    .d

    cAe nucle r.la&tioq

    .fcd.

    Typ.A hlveb@ lpplovcd by FDA forlowbsc*


    nWloiiro which

    a Do1nt

    whicl rotts Clositi(hm Bor'rlinr@, ln.n .tr d

    wh@ lhcy

    o!*ud

    Fddts Dwle dElction sd quilg


    ord

    r.d!6ior

    in

    th.

    trxc

    bd

    nuslq

    ulG ldile

    q,! ofn

    rdtche. including .piedic digninc. toEo._iype h.!tLc.h,

    b rqlcr.

    us.dfo. tBdng

    r@ru oiefi:..y,

    but

    to

    dl hlds of ditr@t

    !id. .frer. Botllinu rdin ns

    |itdrw

    .r lh.

    teeat
    san glads, o sphitds vill

    Aaeid P.nltsis, Ois

    .divity in

    tu

    rde & dzym. !.dvlcholin. *bi.I

    dirinM

    hed*lrc, Thc

    sm. tho!6

    @lM vasodii{4ion (dpdnsiot ofblood

    Tosion it?c hclda.lE. Botuliru bnn i.

    ttis bsderis

    choodq@dio

    to

    $!fd, emth s

    brings blood io ih. body's

    1.5.28.
    pain

    lhddiv.

    appliiion ofw@rh

    vsselt whi.h
    .nd cold

    oths

    a{i .hmic ddlv

    als t ptle with rcpdt! or

    lek of pmf of b6etu. At pffiL

    rc 'lotidts

    who do

    is ! dEo6id ed uprevd lbmPv. v.t thR


    'l
    spond lo tteaitbdl, ed lon rdy vo..l ldrcates" Wclch . .t al

    42001).

    1.5.t9. Ro6trg,

    RotfrS6rl dsd-plissEb6$gq whic!rEl43rt63dd

    inprcving hobility, postuq b.locei ed

    Pr..iitimd !!ply sl@ pr65@


    tbe

    $n

    iisa

    Rol6ns @n@tr

    Fic@s in ih. uppa


    h

    b.liv.d thlt

    vbj.b la<ls
    Th@'s lnlc

    ro

    i[.

    wirh

    ld o.

    smurding

    dv.lopd by Rolf ( I9? I )

    6.it knu.U6, lhmbs, fo8d, elbo*


    oppGine

    am. ftc p.irciPlo

    tis6

    iuclc inction

    nucl.

    greuPd,

    3ud

    &

    lne

    th. hiccP6

    ed

    md t@hniqu.s @ ba.d on O wo* of Rouis

    thc

    nsl6

    b@nc !ti6 ed lhictd.d wiln !9.'

    lading lo m@losleler,l dt fdction &d ni3dig@al of lbc bodv.

    @dch or

    thc

    io

    .tr@ilva*

    of Rolfing in

    rlidin! p34 sme patiats

    inFo6 lb.t F61ft.

    rqort lh.i Rolfna helps wiih fldibiliy sd

    ad dity". R@hrd

    B12

    dpdio@ts lnal vitsins


    potnrial.s

    ddilid!

    of ncurcp.lhy, It b

    la

    in

    tldue roicc./iv. cpode i! spir.l

    &iml I

    8rd lbalmic

    ed h.iShrn rh. Dti mi*lDtiv. .ftal of dals6i6.

    Sinihrly, B vndnitu

    .ts

    potarior.

    ApoptGiJ',

    due to

    .Supplddt tj@ with tue

    ndtft

    thc

    .tfet ofdiclofoac it

    "Bvilei

    eule lo* bdcl pair, Iindings suggdt thal

    s@ndel dmase

    sftss

    studid E?on lblr ! @nbiutio! of th.vii.mitr 82 tud

    ha 'n.lgFic Fm!6ti6 ir

    a@s; sd

    myrdi*

    (20r 0).

    BvtbDb'

    1J30.

    11

    J6.,

    Proi61 ih.

    t@.

    RGdr Mra & Ja*a

    of th. vitmin B

    pati@ts Oon

    (|

    @Is aeaiBl

    92}

    @Dpld-rmcly,6jmin

    viirmb [8.$b-6], sDdor vitanin [B.stb.l2]-my Edw plia ..P@iaUy @palbjc


    ad nueloctclclrl p.in sy!d@6', wqnr.lt (2006).

    - r.sjr. om.!r 3. R6at[


    polylnsltnt

    .dolMrE
    wdity

    f.tty eids

    th.rc Dly

    of bsdehe

    blt

    std

    bc

    to bc

    rbo$ rh.r

    lurplmt|rid pi$ @.er 3

    cffc.riE i! lh.

    hdrgddt of'Ell@l oienjF i.

    . r.du.tioD in badlclE ttq@cy,

    drirg hol'nat

    with ftb oil

    !'d

    thntie

    and

    olivc oil," Har.l, (Gagn, Riggs,

    vaz, BrcM & Eail, (2002).

    1532. Wdr Crre "Debyddtion


    prcducing

    probld of the

    hud

    rcgioml walqshonige in ihe

    e@d dd wdl

    in<rle
    tbey

    sud

    b.w

    los of frDclio

    in rbe

    lhe

    hujm

    body

    alm

    sd thd

    of p.in

    ddryd@tjon muld

    p.iDfll

    omon

    f6ctor md pain

    body' it is diablish.d whd lh@ is t

    oui lhe toricins in th. body.

    of bxi.,ity.
    doing

    is th. pDDiry

    '6.

    is oot

    ft. nd.

    @ug! Aqh v.tr'to

    @ding

    b th6e

    sd fo@ th. p@n

    inct!4 bnciry

    Th. ph4u. fom.rion

    sw@ce of

    iD

    io slop doin8

    go

    sme lhe

    wh.lwa

    wane prcduclion-he@ tbe

    0! bdl arraid re ous.d

    "b lr..tdml ofcht@ic


    supdior lo

    dy

    Poit of thc body, sinple vala

    pain ndi@nof,. Pain

    nediotion

    shDt

    doM

    lG

    th

    ndicinal .tr

    disa qll of $c

    fr

    bodv fo!

    wald bui do nol o161 th 'fr.sh w.td shotug. in ih. ittaior ofthe hodv fd watd

    whruth w.tdilt.k cdcl lh. bsi.


    fidrhc dsad, D@pl.

    .El

    ''Mignirc @ltiry fon

    pof6ionok", (BlN,
    H siat d

    ofwald with

    pain Prcdeirg deuehr

    si.I thcy dG D.hytltd.d' (B!tno8!eldji.


    dEttydr.tid

    the

    is

    soD added Celtic

    to

    66

    diMd@.d

    nda Prcvios studi6

    lh.

    lirddw

    but

    am

    1987).

    t@eniz.d bv

    n.diql

    cM tbiBl Bv dtitling ile tielt mbitulion

    o HiMlltd s.!

    of.vdtding fton

    1J.33.

    oDnon

    thc bodv

    2005).

    'Do\ ue D.dieb@

    nuch

    ud sE

    sdt add.d, lhousands hlve

    b'd cu'{t

    deinq h.an di$s., ariltritis, RSD, Bek paia aub

    aoFncn|fr. ardcidt

    sppon

    lom

    d bv

    innuc

    oihdr*scfiet'.

    lfchitFm.dicinefrs|Mtio.d

    in 581 B.c. a sdll pacdc.d in C1i6 lodav

    Acltude

    in

    hs b@

    trahdt forladrch6, docMds $egdl lh.llh. ptE d@ e* old


    40000 y@ !8o, Ii is hDm that it is Bldtiallv.ldlsique fd geitiry a siidl$,
    pr.fdsbly a clnMl jntolhcc rsl Ndou systd Th.bel points to N' @ lh$'
    t@8Dz.d s

    nd. fibd
    .dj@t

    lo

    @ nost

    4ily

    apch.bl. ExePl. moto. points, orsss,

    r{apucllE

    nis

    bd

    RM

    of barDd

    Ecllein

    is

    ucatai4

    l9??) $sg61!'d thd

    by al leasl two pah relieving

    kv6cd

    6 0r cfrd

    @fm.d
    borh

    lh'

    on

    pin

    Pd

    and

    $846Ld a likcly h.di.io6

    Ch68 & Pobe

    s.dht.d

    'l6$t

    tL. pain thr6botd Th.

    homonll s)51@ hq

    which is

    notd Poinl!

    nd @ls &d 6b6 R.!@chd h.w foud thd .edle 4e 'tr'ds

    .!d rh. lddilaof elefi. ol@t

    or

    by naloxon & lh. othd

    m4hdis,
    b.itg

    thc

    orc

    A@pudw d'lg6ia odd


    !eit8

    lhe

    ddotphis svstd,

    no! adolpbjn sFrm' Prebablv

    smlo

    involving

    n.ut6 ofih.
    w.ys, h

    n rnd

    pdiacqudElal

    ona

    to

    gtt hstt r & $

    ai$

    psycbological

    stinulate atdogaou pain @ntrol palh

    nditid.

    mponot

    lh. thEnold of pob 6 werl

    @pl.t d.lads d
    "Thc

    of

    in

    of

    sws

    1o

    didde .lomtd.

    it js

    rin r.lief i3

    lhal

    A.upu.lu tE

    blo siouly

    oEidlt lle sLlw-. (B.mio!A 199).

    lditioml id...

    chrcnic

    d d intdal dblurhare of dg@

    b|dr.g6 6Bing

    wqrhd fadors. A@rdirg

    Gdl bhdda

    chd.l

    typ,

    chdcb

    &d

    by

    6tri6

    iD

    h.td&he

    hqd..b. &d migiin @ lrtiblt

    of Ql-in tbe yeg cb@.ls of lh. hd lh.

    b. P.in in

    Adpucte A

    p.it dd .is ph,mMlogicd

    Acupuicte atd @prBs@ ba b.d Fs.iic.d for


    A@rdilg

    of

    3 b pr!d@ sFifc e.l86ir

    ihc p.tiats, thBlDld of

    sh6 widt

    a r clinicd tm..drc

    ce.!d

    @taiting

    B Endo+hi!

    ttlmd simik b rtEdtrrou .L<fidl !d6 ttiuLtid.

    Th@ oay b.

    lftM

    mela*.pbdil Acupu.nE etnul.tc

    to

    lab

    eci6t

    and

    cotr

    Plin

    ldm

    ./

    il

    abov. the cye

    i5

    on

    d io

    @sdy

    ! block!8.

    d.podot

    exldal intluoes

    bdidd ihdt

    e foutvpc

    SheYlrg ltadlchc

    tL. l@pl., Yrl8 Mira Hdd&hc

    o P.in dons ihe Eintty btsddd cbM.l, pdn b.twc.n lh. ev. ttows
    d. Pdn
    20

    Flded io lh. livd chNel, in ih. (vaLr) th. Du 20 B.ihui had.che

    scp.Bl.

    a@puctu

    Poinis

    e lin d in vdiou @rbiEti6

    fomul$ $gg.st!d by aulhos s efre.liv. for tE tratEor

    ofvdiu

    $e

    dilfdEt

    tvpd of

    hdd!.h6. HoeG, ln@ ir tu uiv6.lly x..ttd fooubehov46

    in tbc

    G.B 20

    .rd U 4

    ron inportsl !o!rl!.


    C.B 20 is

    point

    jul llrelt

    lo th

    traP.zi@ musclq !t itr insdtion into lhe

    @ipital bona StioUtrli@ h@ is of gElcr

    !d 169

    @iPit l @c it n

    ftdy

    stiDdatid h@ vould afrd lhe Colgi ladon

    dgs,

    !l

    the

    iEation ofthc supqiq

    trap@iw 8d rh. rihNlido Dadoid mwl6.

    'titldiDulitettcmlorpoiltsofth..torsdi c,rE$.tdaddrdqnu&16of
    t!.

    rhmb. Thi! h th ho6t wid.1y N.d of .ll

    @pmclw poinh ldli@laly fd

    aflictions ofih. uppq part ofthe tody, it hs s signifi@dy latg. repres|.tion

    srfae

    of

    $. mbnl anq.

    poirr!-if lb!

    and 80 ro IOO

    dinul.t

    stiDtnrtcd witb r

    *iO th. a.rrEtior of do*

    b. Nefied bjlalBlly inlo

    cumi ih.l altdndG baw@


    dy!.tpbj! tldPtN

    Mtial

    '|c@ltom(E

    od Lj 4 e Ned, (r@iondly a D..dl

    GV-20 |r rh. bp of lhe sdlp

    tdponl had!.lE
    pain h6

    ndalehlilr !d

    Hz B.t! otdorphi4

    G.B 20

    tupl.

    lla

    !.d16 N

    N.dle elclodB

    ll is

    sspet

    nft of. pl&6o

    fd had!ch., la$.d

    d dar locltio!

    valu. by wty

    may clso b. plac.d in d oncha of

    !t th.

    For th.

    aiypicd

    fadoE

    rrato.lt

    a.b y@' n cdld $ ph.d

    th.

    lsd. N.dld

    the

    lbe in a@.d wi0r


    For

    tstMt

    pain TMJ

    placed in
    rhe

    .E

    of poin

    tL.

    dPhint a for
    ST 8

    fd

    6npl.i of

    and

    .lehi..lly

    lowding ofblood prcBs,

    tbe

    ofpain b lh. fa.id r.giot\ tEtr

    i! u.d bilateralM

    of

    auietv ed !!3, th.t @

    hadach.,

    f&i!t p.in, TM, s,nnnD,


    Li

    f&irl

    ii

    d b.

    vsla\, d

    patidts

    Hz

    ofnalitS th. plridt "wbqE n hdr3" nc.dl6

    ud . garal c.lmite cff4t Flidirg

    omody ctiolo8ol

    al rhc

    of th

    th6.

    2 ro 8

    fd noduhtion

    de

    so oft!.

    stinulai.d hav. . ddonsrrable va$l c661 Fod!.ine


    slowing of pule

    in lbe

    on

    .d

    00!6 th.

    se

    3 tie@i.il Fr.l8i4

    p.ncipld

    thr! is th most powdftl poiit

    6.

    Conch! of ach

    d.

    follow.d

    fd P.j!

    jn lh t8ion

    of

    Orhd ftedlB 4c pla.ld 3bour

    ofptin oi p.Oolory.

    i! ln. f.cirl Egjoi $cll a Tdgai..l loElgi{ . tyPicil

    srndMe, ed dh@ ih.

    .d.

    Fincipld m follow.d. Wc

    Li 4,

    bihr-.lly
    d

    w.

    ft.d16

    in ih6

    palhology olhd poin! u..d


    sT ? is

    udd

    ST ?, Sl I9,

    thc euSDatic

    In lhc

    Li 20, ed ST 6

    eh i, Ao oftht @ldovl ofthc Dedjbl'


    jN; 3tisuld. hi&cle

    hollos 6rt fils upo! opqi!8 ofdc

    ST8

    d.ptsion brwd th.lF88

    !d

    mouln sligbtly op6, stinulaL h(&ch6 of th. hcid

    Gv-20

    Bi!.di6

    sT- 19lr

    tud

    op6, ninul.t. th.

    .lc lhc

    LI-20

    li!.

    rrE!,.l lh.

    Yhich

    ofuppd

    2r3 and

    gsls uiculd,

    N@ltbid

    fold

    lh.

    tudibdu

    joinl wifi the

    nFd

    sthll.t i!. Stdld @ipital lde


    lL.muth

    btd.,

    wh@

    of V and f&ial

    |@.

    lowd l/3 ofth

    f@ial,

    in rhe

    oflhc tatpor.l .!d iDland

    ed tdpotat

    dqr*io

    uicdo tenpod btw!

    ST6 Ju.tion

    Firt stib

    oftbe egittd

    of th. t

    @ ofpar

    @od! ofc, othd !.d16 pla.ld in thc

    D4dd 6scl.' at ft

    8d ttaetaic

    vithit rb. fold of.!.dq

    .1

    is sliehdv

    notor

    rd6

    tb.

    ld.l

    of itfqi@ .dg.

    ofd.

    nsi; stimulat6 infr. otitd bruEh of V sti buasl bEEn ofvll.

    Th*
    r@

    sditiv.

    Good

    sriDul&ng wiE

    'It.

    points

    ona ued bilaidauy or

    red|s @ ale b. obbin


    b. .n&h.d b

    followi.g poinb re

    Sr s St ,14 GB 20

    r+on

    d in

    is

    ih. h.rdlche

    for

    or

    if

    lhtu is

    d hqd 1be

    poi

    thcv

    20 Du | 4

    n@.ff-riw

    oflted..hd

    l.

    ?oini.

    u 4 Li I I

    s ds b ustd

    t nianjtC'tbe drnv tuil

    PrnciplB for Trat ndl

    scld Go@ins

    by BirSrbe optosjt f!@

    6.d fd bad4h. ndaaadt D!

    !..dld re inst

    th.t Act'pErdw

    ofthc plin

    dy ondiot llr.l@

    Acupoice $dl cW
    2oo2)

    th sid

    (251h

    Novdbd

    thd &uas h rcliaing dEBjsqv of

    Du20dEx6

    Sd.dDblPtu
    sd.d L.c.l P.h
    s&.Ani!.fd
    Fardl l}.nd.

    E{&$44
    Accordbabtncot

    L.dd'

    {bihtnflEr

    Du2lYBl 6

    ula'!14
    st8

    BI&82
    GB T4

    Ill23

    T.qdl|..r.b
    D!2dAt( 6

    ualg{
    .lel

    El

    68l
    Sqiio Zt

    Do

    ZYB 6

    ua

    3t a4

    &SrS-ii.Srd.r.d.litl|firFoirti!H-lrLd'A'
    b.dllitSitt@l
    h20
    u,1

    rlg? tlrB 6(|dili

    tuldltt

    lail

    Poim GB 20

    vFdcal Hd.che
    Du 20

    Li4
    Ub60LiE2Du2
    L..d

    Point Du 20

    Uvr3& Li ll

    iMia
    Gb 34

    Ei 6 .nd nssg.

    ut

    is

    is us.d for

    uidy

    fd d.pBiotr 4d

    fohlFrd.id

    sfiitd

    Sd',tun n Electical Sltulatio

    poi.!. sripdctle
    @ !l}.1.@
    reNlr

    is

    e ttrdl

    thc 0ow of

    ofblo*.d

    @agy

    i@ff.ial *intldid

    whiclt

    mNL tddos

    of rct

    3.d.tiw Fina

    @diprdd Sdjio 6 for

    for

    Hdr ?

    & Ub 62

    StipEde Elctricd dijouLdionofdagv

    ws ilvml.d in Fm@ *ith

    die r.gion whae

    b r.qdE4

    lbj5

    $c paiq if thc

    ifaa6/

    is

    insmd! w.
    it @uld

    be

    ci@l.lid ofddg/

    blod.d, ditpasion

    ds io b.

    of

    $. poi.t

    to be slimDhld. Elch point is

    n.d fo. l5-20 sdnd!

    to.

    If odSy

    is

    Le

    is

    G30

    tho stimuldt

    nw dd it tlsls

    60

    throusD tlE

    sitttcd !p io a d.?i! of!


    d foi

    distdsi@

    .ffetirc

    sli!

    io

    wiih

    is

    is

    donc

    a 780 n

    siinul.l. lh. A@pwrd

    6dndd udd

    th. skis

    s&.q

    6ch loint

    30{0 wav6 of ?50,000 to 1.000,

    Sotuperdc
    to bc saf,

    d tb.

    .q4ucn!e Ld6t d4elolods @ diod. dwi6

    v.e.ldglh &t
    loids wnidr

    blet

    iL

    &o.' th.

    iGtuDdtdct.silt pBi!.l@lion

    .l@ricdly

    cmpg

    Dsd.

    cEg i! ou b.dy, if ! pldat bs a Fobl@

    ii

    of ftligu

    md

    Soud

    qc

    rtdicd

    lotdly paiDl*

    to

    lclplncnm ndidid sy$co G foud

    and have

    ofsrimllorion ald hs @ .ffcdjv. d.pd

    patiml acc4lbility,n

    ofpa.nldd of68 @.

    cqui6

    30'

    Moxilusnon: Monbs&n

    Mo.ge
    diffffit

    is

    lh.ldintcd dsjvatioo

    of the

    Jspd*

    e u.d in

    Mor4 in this the lav6 oflh. ndicitd nqb Anditia wlg,rit


    f<)m to .clivalc spdifi. points o.

    ud rrpli.d diEdly d indidtly

    ro

    *m

    *o.d in

    .dlah .@, tt!. Mor re

    lo !@plDduE poilts

    iDit d

    s . fod ofasEEt lte

    ia tdt

    ecll

    domdl.d

    ,thd

    @rstricri@ oI loc.l bl@d varcl! is dilst4 thB bringng tboul

    e inc@e

    in lhc

    p@ie phFioloslcsl Bgors of the

    bl@d $pply ,this


    waluatcd thlr

    body lo hcd

    t lid6 po! tnoc ronB std stlt6

    fr6tis*

    ftleht ofnirnb.

    of AcupDcnE

    wnn

    Ad.

    tu

    tresdy

    ln 2008, thc Cocnm

    datoor ortio.

    for boll

    ihe

    sF

    njlod.
    whicb

    shens.

    vq

    @fr

    to

    Rdi*

    onclud.d th.t

    @ndlr:ont'

    i!

    DAin

    ofttioev

    t..d individu.lizlion

    itt cffciacy itd b cldi& ils itrdiolid,

    Cl&

    @pucift

    ahould bc

    @Ni.la.d

    st'd n.dicine

    i3

    2001

    tm

    sl$ knoM s botai..l n.di.irc .nd

    lMchd

    id@ri6cd 122

    "Ethro M.dicd" Plar

    ph@h

    s@!d..y bd.bolil6,

    .4

    oxygd bs.d tltiivativd

    or thcir

    Mba

    of hat6 @ lhough

    adultqllj@ in appoprisL foBul.lion

    I@d ro

    or

    la.k

    suh

    lildv

    to

    w.lla

    mpouns

    30l[6

    Mdy pleG 3Ffi6iz subnM thd @ esgt.l h.inraitile hqlrh

    hms, Matic

    (2010).

    ofhcbtl nedi.iE inclld6 6D8d ed be pDduds 6

    dd cdtain @n l-D&ls. Ir

    us.d

    t*d.b

    AcuprD<re ofr6 bd.fi& in lbe E6tnan

    r.s.34. H.rb.l M.dl.hd. HsiJ.lim


    lblro lh6apy.IlE

    th.

    led

    vsls tul@irg ir th FoPhylactive

    nsdlch (tulcran. ed t6'ion tyP.). AopuDctft ntbod

    A.lditiolrl tBgr.!

    Fatq

    th.

    innial

    ir

    6 iMins Mev

    c@ dY* ef.4'

    ofudesleditg ofpl&l dsg ola!.riod

    n@ hlm lhd oought

    Hanaln.dicin onbin.thousddsy.d
    two OiDgs rd to b.
    slthouSh hand

    M@ba.4

    td.di6

    t !d.d

    1o

    we

    do1 tully

    h.

    8db

    of

    Pildonwnnmodms.@bul

    bddlld

    rh@ drgs thcv

    ltot thet *ott,

    sndlv

    6uld

    ifiat@

    do hari4

    iD

    xesiv qudtiti4 ed @uld allo

    Mdici6

    tl$ !rcninddy

    hav

    !dv@ jitdc$@s

    ur.d in lh. fi.ld of Fin

    n dicir6'

    with

    Hdbal

    n@8@at nm e nmba

    ofhatuwhi.be!5.d1068hlh.st&ie l)f.v.rfdisvayPopuldmignit hdb.l


    m.dy, 2)Fppdjnt ha !@

    llta 6 t6 bcf@ H

    cdniie ltab
    inflaMabry

    dtrd.ly
    sid

    !o

    and

    hadsch

    n@ oxvsa

    nmdt ed

    a.! (Pasi6 httrid @r) s ! bjcnilc


    50

    na to

    ndilsi., Klu

    150

    ndc

    Rcql r.seoh6
    of badach6.

    ng i.

    cltrci*

    8@

    Bay

    Pasim tlowa i.

    is

    ds!lia.d

    th.laf

    to

    h.ve

    dri

    ha k m

    of ginlo

    drrnes

    s w.ll Gitto

    tsl'Mt

    3tudy

    br.it, hae mt onlv

    Tn. do$s.

    roDc

    c$e

    side

    lumadd

    trdolq wd u$d tbicb b I blna bu

    lt@I, @trcq @!yd.lis' JMai@


    for

    dog' for niSraine

    tFou

    hd.cltlq

    $d wdd bct.nv

    show rhal

    bD

    io lb.

    rsion hada.rE d!s@ l6f

    Kav. for

    val@in for hda.he

    sffein. hs dalgBic PtoP.ni4

    in th.

    neagdot

    &lg6ic !dj!vs! *La @bin.d wn sdhinoPho 'nd

    t!d@s hadach. pain'Ttuid sd Mjst.ine Dimoid ( 1999) stldv wd

    AsDirin

    @rduckd to

    eftiE

    lss

    ptovid

    Al&n

    lh. ue of lbupref@ plu 4ffeine in hadach4 Conlirtion wilh

    $pdid u.lg6i4 Diamnd, .rd


    iv

    Diolrric dd

    r.due dicty sd

    Fredai.L (2001)

    lbenDld

    1J35. Mutic Tbd.py. Muic

    bos.d

    P|lmls sl@.!d

    .!d

    ttrd glr

    blt imprevirg

    cxt rd. Othd dogs usd

    of the

    3)

    popnd hdb fd bqd!.h6 bll lhc m.di6l did@e is still disput d Ci.lo is

    Ms6 fbm

    ard

    d a bctd..,lE tmdn

    in tilting prcpcni6.4) Ginko Bilob4

    ibpov. tlc flN ofblood

    moving

    .f.ff

    us.d

    hG p.in rEducing

    prin Edsins Fopdtia of

    f,cic

    p.in. {S@tle4 2OO3). Msic

    such

    e.tl

    thd

    irv6ltttios

    nuic si8nifi6dv

    lhdpv k th. olinj.sl ed .vidoe

    baic fd

    dming s w.ll 6 9Niv.

    l,stmi4

    ofnwc inlervatioB Hahbv

    vi! activ. nsic msljng

    .trc.b dpincd

    individuols

    tlr*
    for

    ttdudion

    rclddi@'

    Maic

    is

    for pbysiol

    ond widcly slpFn

    d@i*. Muic is us.d ir gdcd

    lpspiLb to

    eld& mood ed d.prqlion, Rceatch ha shown th.t nwic ha fobd fi81

    ptcl!., lh@

    bodt od th.

    lB

    whjcl,

    nusic to

    hal,

    sd oIhd,

    il h

    mvdat

    ard Muic

    d$

    is

    lt ha b@ lorbd uctul ir

    ued in pah

    lf4rs

    R*arch ha shou

    'gEt
    .ldt

    syr wilh lb.

    thinking,

    fo!fl|

    lhat th

    to 3hin

    bo.iis

    ed

    . greeilg 6.ld ofhaltb

    10

    nuic

    wirb rh.

    with

    st

    oM a 6uic ibalpy,

    c.'E p!ti6!

    Mrd of

    dcprsio &d

    ng beat

    io

    pbnote

    stinolai. b6in wav6 to

    d6lllion

    faid bet brilg i! 3b!rF

    slowa rdpo p.miring

    childro eitl ADD

    Fsatul w.rs.

    |h. mir|d .r'd tody in

    th6t

    let

    lmagddt

    .c t

    on thc

    qld, n ditativ. n

    rrd @G

    ra Rs.Nh h$

    chaa. jn bni! w.v. ..tivity ldch th.t mBic @ bring a!bl6

    ds
    ihe

    b6in

    .m dily o iis oh a .c.d.d- Wlic! naro tnlr ruic 6 brinS LeijrS


    to you st t olnind d6 aftd yo! b!v. stopp.d lisrail8; thft e olso

    s!6d

    ch&g6 in bd$jng ed
    body turdion, tlrce

    nL @ al$

    b.

    do*d len

    d.

    .lt

    bdr nlc, wirh altq.ri@

    go@.d

    br.in

    vrE od6

    ch&a6 jr oIha

    Ntolmic rdoE syslm, och a bqthing ed hqll

    by

    r.d by the chds6 lbar

    ed

    in

    in rdivation ofrh

    huic

    brinrs, this

    Ela.tiod

    6!d$,

    @ m@ slowd b@llin8
    Mcic

    @d mBic

    rhalty

    6 euld th dhogiry efldts of cholic sr68. Gsdy pmoting r.ldarid md


    hahlr Muic s b. u$d b b,ing . mE DositiE slal. of mirA lo l..p d.pr*ion al|d
    di..iy

    !r bay. Mutic ha b@ found to lopd bl@d

    & idponol

    it is

    .ls

    @mid6.d

    iool io @ain hcdthy,

    Ite

    b.low

    All

    fom

    ug @b.*{

    of

    Dsic

    tbory de 6v. iltmal

    Duj.rl

    p@@ ud

    havc

    oreu

    on

    tdrlition

    l.rd $iati6c lhdi.s,lhly h.E

    thdaFutic cfrdis, a.ddinS io

    ard

    nBidiu ,tstds

    ton6, vhich @ u!.d !o doEaac hdlins.

    chil*'s

    de b.lided to hav.

    @l

    b@

    Dcdical

    ffilordirg

    Ttas of mujc difra

    huic ns b@ foud

    lo

    ir lh.

    iype of

    slib .tid

    ndmlogiql

    thy

    qot ; cl.sdl

    eEc @nfoit dd rcletj@. Muic nly acltw.

    ils lh@putic

    .ffcds iI prn by ddalils lh. pliD thr6tDl4 MBic bat b. u8.d wilh glid.d iDagdv to

    stlt

    Drcdu@ alrded

    of

    @nrciousd lhlt

    stitul.td @tiv. iBighlE il ill .ts ued


    Rrdins erd ldgrl.g. shlt. Th@

    tu

    thc

    uwdltiddo @otionl epou6 dd

    l@l of

    in tbe

    h.,

    thlr muic

    of@ phil@plE hlhgoEn

    miing

    cls trd

    in tb

    widd..

    sli depBdls, M6ic hs b6 u.d a


    ir

    hclp

    dw.lopDai of

    inctt@

    6Fntiv.'B

    hdlrg s're &ciot tib6. ApFring

    Atidod.

    !d

    Pldo,

    Nttis Amat@

    dd olhs ildigoous epup6 hav. sed nBic to @ho@ tndition.l t.lbg

    6hri6 Chi!*D.didr6
    mlodie
    3tal6

    u.cd in

    (TCM)

    .lsi6l nsic itr hdia .,i

    Plti5im hlvc

    bet

    us.d ro

    @r. diffGr

    ofosd fq heling.

    hUM,

    in *hich the

    dpmior

    of

    lm$ qpsnd dE

    to

    d orral bElllina

    orCs diaphragn

    Elh6

    tlb

    is

    d.

    l!fua

    of

    d..! latuil bd'.hin8

    abdomi$l b@&ine, bclly blaihins.

    a.l ofborbing

    d..,

    rhe

    di|'hEsn @edy,

    bralninA by sloeirg youbElning

    Et

    ,.l..|te

    is

    &d mqgy

    iriadcd b n.b you

    !o

    pmF u.

    bMrhirg .ha4ps @

    of diophragn ic

    6cs rsporu6.

    srdgb

    dcs

    l@gs by

    odin8

    lhe

    dd6e

    ih.

    6tyaq dd,trd ud

    wt of
    w ls

    efon

    b@lh. B@thjng patttu both sigld md triggd speifc ANS dd CNS

    cpons tele

    wivsl

    into

    brathjna sbdlowly by fleuS ot!'s nb c!ge. Dilphragnatic

    br.dlfng

    ir

    th. lowairg of thc di.ph?gm Rthd lhm lhe

    d. ch6! Daplngroaticbrothins,

    dc.p brtbirg

    th.

    y!.1i6 fd

    @ nuic fo hdlitg, ft.ditional R ga &d

    lJJ6. Di.Dlngdltc BM(Itng,

    Th.

    lo

    I1E

    of $e

    ijllw.t

    bRthiry

    da8oc, or'6eh

    6
    or

    d by

    hlp

    bod rh. ANs .!d cNs

    @6.

    dt!tunctioml @ae6cy

    nid " r6!oM

    is

    ! valualI. @npotrst of

    final rld il allows fd lh. in |'nta@u h.iBhIai4 of tu

    nn swival

    udd lif. thred.ni4

    onditioDs.

    crons,

    !d

    Ealy recosnilion oflhis phoonma od

    bFtling tehniqM @ @Mitarrly . Fw.rtul

    dron

    tic

    cpo's

    rc iunw&d

    B6ing ney

    dtsfibcrion

    Mo6r

    had!.he

    to

    abddinil nscl*

    to

    Ftiarr
    uiry th.

    db6e

    thc

    d
    !q!i@b e idvtu d lo rct mE lbcc ".@sry bel6"

    no\ebt

    ofth di.phr.8n. Ahdmir.l

    xndarioA

    Mdy,

    r@l in

    ih6e 1e.lniqB. DilphEgtuii. bEihirg is simply

    diapkaen fd bsthjng, Pali6|l

    which

    dialbrarndi.

    ad qr@!!r. nadad*

    which Eia86

    l.ain8

    ould bocdl nof,

    u. of@r.cl

    the

    DNl.

    sociai.d with ddgdcy b@lhii&

    qps,rds on

    i.nddid ed mtad

    includine th. uppq cb6t,

    ft.k dd

    Di+hgmllic Bathirg telDiqu

    Li.onyoub.ck@aflal$rfdwilhtn6bad&dyoqhsdsryon dyo!
    @ ue llE lnow uda yow kn6

    allo$

    Plc

    oE lD<l on tbc

    F!

    fel yoE digldgn d@ s

    to

    ir

    B!atu

    I'o&,

    Th
    'l

    p!a.d

    to suppon you lecs.

    l@d

    fte

    clBr &d

    thc

    olhajull b.lov lh. nl ogc, ltis

    you bFrrh..

    dowly 0uongh you nosc so thal you stom!.h

    ieht n yow

    lips.

    lpF

    rh. ch6r .hould

    chd slsuld

    th. .l.eo<16 of rlc EMG bio f..db6d

    d$dc. l@ing

    y@ qbrle lbtuugb

    t ciniq!. b mosl bdptul

    tmiid c .tb.!.d

    ed aHohinal Ducld @y
    To

    you

    h.in a stiu a lossibl..

    Bio f..db.ck alisied pacd@ of thc

    1h. DcdoEl

    agEDrt

    @i! s still a posiblc.

    n@!d o@ls, Idrir8 lhd fin inwatl a

    halds on th.

    nov*

    .i$

    md inr.rn

    to

    t&

    @d

    uudly

    Eleiw mel6.

    b. DonitorEd.

    liatio.

    all patidt! @ r.queld lo

    ddcis fd I GI5 minnrB .r ldI rwie r d.y. BElhin8 d6ds


    wha u&d with iMgay, rcldrri@ qftis ad .utogaic !ha6 F v6y .frrirc, In
    pncd@ bF{hing

    r.6t

    xpainal

    using

    ql-tiD.

    brain

    iMgjn& sciattts d@@!tat

    d tb3t

    individuls l@ed

    to

    niiiSde

    the

    sa6tio!

    obsruc

    activity of tlE

    p'lGsine-

    ln d@ry, n is posible for

    cli.t

    You will

    is

    p..!1.

    dlaide

    1o

    di61

    of 1he

    sa.

    btr& Dd f.d, nusl. ElurioA rln .


    ed natlEl Digmi& Elicfskills
    dil'hl8Earjc hrhing,

    Diu

    that rydy

    of

    EMtirl

    w,ih th. ain of

    oil @1aiB lh.

    tlru8b tr6Df.db&L,

    priD

    D$t6

    for @tural

    sFiocirS . sming

    lrsla lD. Or.

    niSllin sufr@

    of dE nosl

    should

    m$s

    6stid

    of

    valubl.

    is

    oils

    pdrning balth rld.tion ed feli!8 ofwdl

    cloe

    in thc

    (2009).

    15Jz Almt Tndpy. ali@ tid.py tu l!. @


    ton pldts

    th.

    of thc bnin iNolv.d in pain

    skills you

    likclt fel lh. !fr.(rl qlicuy

    olrolli4

    cGciouly

    RosF.lelqid Ci!gul.t.4 d

    Dialnrrnatic bothinr

    nignirc

    of p6in by

    of ih.

    ple !t'd ha t@ u.d

    dFd.r.d

    ning.

    c6turi6 for

    for

    {d dti

    thdDcnic Flpos. OiL hwov&rirs proFti.l rn 1e6i.. &tisepdc

    inodmalory wnicn {c @nndqEd lo .dd halirg od Eldatim. Althougn th@ k

    dql of e..doral didocq O@ dist vdt


    pr.vot th. o$d ofhadrd. I q

    @g.d

    in r circl.

    Doti@

    ,ek. SMis .le i.diqtc

    !.@n.l repolg

    ro

    thc

    dFF

    .m

    lh.

    fqw

    of

    o.tol

    .bjlity of Ldon

    d@tilh

    (Aloisj &

    Applicdios ofhot lrd @ld fondtrli@

    1.5J8. F.lO
    lbout

    q?n4

    E..lir& r.ib

    haliry id!6lhsugD Flys

    pr.se

    d6dd

    heling

    or ntu.13

    srd pows towlr& @netins

    Am6

    10

    oil

    io

    !4.

    of olive oil is

    8nd on lbe bod( of

    nodul.t.

    c@eu,,

    is lbe

    tbe

    ce

    Therey

    bv6da oil Mlh 6v. droF

    ldpl6, h.Siid

    rojeflio! ad !.in,

    nirut old cmprs. Hdd

    studi6,

    gpl

    tlc

    rh behavioEl

    2002).

    ofEe]r -

    niruld !ot, I

    bldrd to rclicF hailachc .nd

    bli.fLhrl ..ligiou

    th.t.crdina

    lo

    ftih

    kirS

    dn.mls mok a divir.

    &isi6 .rd dislbility, qcali.S ha

    ba

    Noci.Ld

    MlL etgjoi, Flith haling n


    ch!rcn, Dosq@s, or in

    6icd

    pFys goup

    thoaFrtic louct it is off6 eEcd

    Pny.i

    1.5J9.
    ainins

    ha

    ro

    @D.d *ilh

    Prata

    inpreved hallh.

    hsl6 d
    ncds

    th3l in

    dilc

    cslirg fd $delhing while

    or

    for

    bt!.lfofpopl. pho @ ill

    or

    ir

    b.y hsE sFcinc objciiv6 d tuy eish fo.86otl w.I bcirg,

    rd6

    lo

    p6y6 $id

    lnidq$ry p6yd my

    Eletiw

    bc

    bq

    or

    pdf@d

    il.rnutioc

    to

    tn

    {t&*

    fdilis a

    d ding

    . diste@. Cld5,, spiriturl


    lh. slinod .rd dodoDal

    lov.d

    06.

    su88at.d, tbar D.tia|3 who pEy.d lbr

    ilEelves d @

    pnyirg for thd, nay da.lop sfdSd 6ping skills dd

    d..Eed

    my iDprcw hald! me p@pl. belis. rh.l prayd ha b@.6ci.l

    which

    ndous syrtd

    pmr

    fi'ft

    ed wek'd!.
    6kd to

    d cl@

    fd lh@dv6

    ilt imue 6t!il

    s8s6ll

    a.-1

    tou.,h

    lhmughout bisto.y- P6plc nay p6y

    $dned by th.n

    thd olhm

    otns f(ms of bolins, tub

    plrdte

    ofFhysic.l ed mnid p3tiats ihen

    didy,
    on

    defi!.d $

    in

    for th sick

    II t63

    aw

    be

    bl6 pl&!

    . disr&a .!d ned mt iDvolle,

    ou1 a1

    dy

    ulit.

    Nudly

    tr sollld objer ofwdship. Pnine

    olb6 "lntd*sery F!ye"

    inrEM

    meeting

    God

    ba . o@n

    n..4

    h rligjou satiles

    out

    intt1:$ry

    or

    q.diovrsns

    or

    .feI

    hmotr.t stsld. Rqarch

    pnt6 tuy r.due pdtr frtS!., tod6Fs! swcUi4

    s spei.l Ayols dd osuy fd plin (App..dix B). 0r padots @

    tullowinS alal I I

    Iin6

    for

    had!cl'. (Speidly Mjr.in.).

    ?>tbL/LtI
    -.h L, *L :r "A i ah Di
    !4r drn,1l
    Th.

    ari

    siolic

    naing

    @stitut6

    of

    lair

    ii

    1,

    J't ir

    -c/ L,1L d./t 4


    'avF-"L'1

    jj,,il t.{tJ.j Jjp

    .pptu .h *hich allows !


    in th palinfs

    on of lbc

    lila

    diftml onc?nl.liation

    For 0'

    palidl

    of 0e

    srurw

    .ppr.r m@irgle6s

    tighIairg npets of syEfloo, (Cruldm,

    l9E6)- lrri@G n6d to

    n@ing

    find lon

    i.6asin8 a palials
    lh. job ofthe

    ni@@ti!.'

    (let ihe houbld 3ool uburd@

    noasdat ofchMic

    tbe

    s e.I 6 moiior.l

    dFi6e is6

    of

    h6d dd sddtood

    feling ofbiig

    thdpin h b
    Ir

    thalpddc .nitud.

    for tbe stbplon, A

    hctdlchc

    &

    tbal

    .ppmach that

    othd

    oFst rcinfoc d v.ll s ro.tun, Hy Ddr'ei.s,

    othd

    n@

    q v.ll a

    ffi.

    of pain in sinpl

    ed 6cn

    ofihe clsnic plin

    cfr<t

    ileir body,

    Th. bsis of p6in

    out

    tob *o* &d

    upon

    Eduetio of

    r.llontlo a td's ofreduorg p|lr6l3 irpul

    rh.ir Fycholosi@l srngiohs. Patidis

    .tu6.roby
    drugr

    actvc physicd

    lddrsd th.

    nu$le straelb@ilg ad

    Be.h&iM ofpdr. Hary dPbais

    pri6t's cronsibility ed

    by

    dl rh. grip4).

    g.rd.ry eli$ 6neci.l copoeIio$ tire

    phy$oloSrc

    hope

    cm thls be imtdl.d. Finally

    F rhologicd @nporals

    .od

    BbB

    Al .ll tim6

    mphrsiology ed

    Dcwio4 sppon

    fdily f@bl@

    Ndsa rd ttqtnol

    raughl th.

    in

    wl

    p!i!

    plming

    @ntonlatioo

    dtsnbdion atd

    . fmdionrl @lt!is: lhi!

    is

    .ds oeridve, Maviobl dd


    physiologi.d 6pone dnD@iM of ih. patiot!. Coitit @B Efa lo baladlptiv.
    psnm. of thinkirs dEt rc uu@lisd. dd dtuion.d; lh.y e ossmed lo ! euslly
    ilcludd dcbjled aslutior of llc pair @Dpl.int

    rel.ted lo th

    tatrnat.
    nsy rct
    3uch

    s,

    vq!.l

    Sll statan@ts

    bayc
    '

    nlintdmce

    and

    wnl

    86

    to

    rl?'at sd.

    he altl. to

    ard non vind bebavios

    physicd actvity have

    bm

    mout ofhoNdork

    dorc,

    of tb. p.in 6npl.in1

    j!t6!rl dirlos!6

    b@ &altz.d

    qaerbatio

    ovM.

    djff6 tob @gillive

    undalying beli.f sys-t@

    Foblo. ' ln.

    hlE

    oll

    ss.s.ni,

    bM

    tinc sFrf

    us.d Mth pajt

    sd

    and

    @s i! lhcy

    d fadty

    .s6s6t

    Mh a fehl grituing bEirg

    lsd in p.in

    Brown, Son & Zieet, 1982).

    rhi!

    Ocy

    ed @ inL.fd. witr

    logic

    @ inclotlc lh.

    g'@s Esrin.lc of

    tu be4

    thlsic.l cxftir.,

    nadache pdiqls, (Kcfc,

    It.

    mour ad

    pai. tnd is n
    th

    speific

    q6tly

    trTe of pdn D.diqrior

    rporre4

    Nsc

    dds slould include

    !!Ee

    mth6 b.vionl

    is

    thc

    miflig@ Ng.

    AF ofpdliativ {kug pEqibcd d l.i.d S.be ofth.

    Eosl

    ftc
    8tiviry,
    .nd D.ir

    6ml

    cFG.
    !d

    'r.rinriotr

    leity

    *lfftrdr

    stst n

    oths

    is

    @ d$

    ofpain b.$.vim

    physiolori..l mG.sW of

    6DoIB

    na5@ h.v. rdi.d

    brw

    uD@

    ba

    or

    .ggrsEl tb. pain,

    by

    oth6.

    ollaLd.

    hdt nlc mugl&

    $.d b 6rioar. ldomic mLql

    p.!@f. ddqiplion oflh. saldy

    physiologiql sp.qs ofthn p!i! int@ity, ey rloqhts bliefs

    th.t tri8gn

    od

    wtul

    ilfomaiion r.s$dine p.in b.bavi@ @ b. @ll@r.d by dirEt obw.ti@


    R.ting shcl! @ bc usd: th

    dry,

    of

    (Mel4k,

    1983),

    d ibag6 patio!, h|v.

    Inttuity ncase

    tu

    Nu.lly 3iDpl.

    nudicndng*al6of sub.jediv.Dibi .tuity,Th.t npoEldpelloft!!.li4t'3


    Dair slbuld b.
    al56

    of

    r,ssd

    ftqudcy

    for

    @[et3 by h.virg lh.

    !d

    dE don. lo.rli@

    Fliaf sh!d.lh! loc{do

    peud6

    ofrbc plin @ th!

    h!fu nsB. d by sinply ty d.sdibing sh@ rh. afrLd @

    th. m.a!@

    ofp.i,

    words such

    $ bhi!9, sLbbiry ald c@ping,

    Onc ofthe nost

    Elationsl

    bw6
    or

    tul

    ald 0E

    th. dac.ibaior ofp.in od

    imes

    vsou

    to d.dib. lh.it

    b&t

    p.i!

    siiS

    u.

    osnitive, b.havioEl

    dtl!|@o1'l niouli. coirire

    prti@t! my

    l@tc4 fimlly

    inponot agels of th. nodiodl &alysis defining

    lhjsiologicd omdon l dd
    $ouer$ bdic8

    prli.r

    quality is ohlain d by Bting

    is

    of lh. plitr

    siiDuli

    @ ilchdc &y

    h.!. th.i t iSgq d lgsnv.rc

    dEir Fin n!r..

    Ihc

    clinicid lhould .xplore Dotnti.l @gnitiv. dtc.dals, Th. n xt .sret ofth.

    4slsal

    strrt sy rnodd

    clinicim !h@ld

    l6s

    be a

    f(fu

    on

    ficr6

    that

    dmjre oertrtio! od dkionioD.

    th. pai.. lh6e include

    b.lp rcduce lh.


    Coping

    *lf stltdDoq iSrdirg

    palial\ rdaity-lh.

    t!.t ile !.en

    may cngigc

    th. paia Einldprding O. paiA

    io

    d9ro. odidi@ e tlqEdy

    Alti

    rubjcrriv! drr.liold

    e@blc

    ro

    ro

    Fio. R..ror. dc.r vd.c

    tull6

    $ e .id

    ni* piirdfs

    !o

    cycl6 ed D&

    Fli6l,

    ffi

    olld Uaqoric iDtav.di@n .rrDiidd .rd rlr(lolo8icd i3og ...d lo

    Mrii.l @uE lirg ir t qEdy

    wy
    Ftlaa b.rqq lpo|c !n toDily t!6ba
    ioFlrrd

    'rlizcd

    in ldptug to

    i! nc it lilg
    TlF tDonr.'.

    .lls nrl d,griE i.tsrrid p.naD

    ocw

    ilts!(iiood

    iMlvqEt it @[ilald

    bva

    4oos .!d

    bily

    !@Dq! rrosEic Erilils i! dlo h.lDfd.


    nF 4p!cdio!

    of

    pry.loloriel @dud.

    &.idft.w..d. M{y l.(rDhE od tlaryy h.w

    It-d!.ld

    dd Fi!,

    tb-.py &d

    .dft

    ltd

    lp

    nypc4

    of ttc

    iD

    rh.

    i[E

    D.(n

    py

    u.nd

    u..d in Fin

    .d

    larilg dMic

    Fin

    FiD diodaa

    3ltlt ryidMo All hadrrF

    !.

    taM

    of

    n40ontvlqFaiE lhd.py.ouic
    & B!da, 200(,) & (w.n

    h6dt

    rlE.

    &

    t.rbhB 0!. e u.d

    Tt@ G bdidly fou

    tt@gdan olhrjc Fi! dilodar &d tad.da

    @!tE!i.srlb.jd.lr6ic

    rL

    in

    coiliwD.5.vio.Oapy c.B.r

    d.flsio Dr!. .rd Di..y !!

    n r.

    Srorp

    S&? I

    .dldiion

    dicd.d b.fd!&y clilidotc8id !t .tiig d


    ltFuld tE .cquini.d

    F io&

    El

    by .

    eitl . Llic

    'dadatiDe

    of

    pydDlogii nuli b. nldiqtly cla&d

    .!d @uutdi6 wilh.FiDry E didl prlvidtlbrelglou Uc cout*ofoatbdr

    ne.3rdt &d dw.y! etul.


    tG Lcy nloc ofSpod

    i!

    SLp

    I $. c.li!i6l i.tavile.

    tanbal ed qi.,

    6. cliniol intdvia.

    fi.td ulil

    Fin Fobln, bo ona p.in Ft'Etr


    in

    rh.bad".rd

    th.

    brallyi

    Good

    butLlid oft!.

    TIF cliDicilD @id&l!d r p.in

    ey Frllirtic d Fydologiql

    .d

    cb!6i. txi! dildtlq i! lilpL

    0...4 T|!g Ct4or

    Ddairb,

    M.la.lq 199). Mrly


    h

    to

    h.

    .lini6l ac@.d i!

    D.t

    inldid

    if

    lologiql

    slnld

    L! fln oh.ir.d .I

    nor

    seoot
    diE6.d

    d.L rlSadirg

    tt

    bdi4 tLl trt Fy.lolo8in vi4! ilcnp.i! B'dl

    atdcd i! Fy.lologic|l Fobld!, @t dd! Fia

    5&

    will

    da

    fa.tors,

    If

    ir a wly

    pBd

    disN

    pnditiond i!

    bair

    by a

    ro

    rcinfoE rhis

    p.iiai

    th,l, dd

    .tt6lpr

    lo

    dis.s

    ro 8d

    ftt*

    thd

    io

    p|qurwly fdu

    p'mi* yd ibt

    ld.dlG

    pq..pri@ of dErpy

    p3ychologicll issu.s,
    wc will gcl io iltis

    psyclotogel

    on

    4d !'!63ine.

    pm.tucly 'l rally

    i$e hrd

    on in

    ih.

    do

    vmi

    ro

    jltavia.

    Bln

    6r* I rcd to nddrdd yow pain 6 b.si s I posibly @, Tb. qucstios t pr.clitiora
    shod.t ask ab.ut had p.in

    & fos

    on

    d.enptio loetiot\ ed 6rn omtme

    4dt!

    pain, Any phtscal or psychologiol

    ocMing aoud

    pain

    of th

    otrti

    frequdcy/irtosity dtlali@j wbat h.k6 O. p.in b.iid/woe; uecialql sydptms

    FdioB

    rrdtrioll, (Bldcr8d &,A. ailq

    pain

    should srrivc for in

    dy int rvid b lhc gol&n

    on stould tB l@hDg fot

    plitr (in !

    cl6ic.l hrsldic cpolE) s wll d

    tal( lbou it dispssiodely, B if 0Ey w@

    Ajd6

    w.b ofpaia

    Ftr de.

    Fd

    o!'. ofoE ltin$ a.linicid

    whd p.li6is @ cn@t.irng

    thoe wbo odidly .td

    lln pain

    individuk *no mllra offidly

    1985).

    dising

    th. walbd

    .t!r." ir'. t b.d p.ir" d qtF


    I f.cl

    lil.

    .bour f.mily

    ndb6

    "bn6h

    oF plin or

    0j

    b.llc

    iDdif@)

    tlo.idly

    sttt 'ils 1ft.

    bFi! ir h big for Dy shll

    my

    BpoD. wha prtidls

    i! pai!

    p.tidt! 6

    hust find

    li. eysh

    @i!.lly iry

    puish lh. palial3 for th.ir p.in, G@d lredndi outcon.

    to

    scesiv.ly

    on thc

    fuilis pr6di thdlelve vith r@nsbl. mouni


    well being

    ed dlow

    al$ inporidt
    It is

    ioFnd

    ih

    n{E

    patiotr lo

    tollow up

    oD

    Frtor

    tuy

    inplicird

    to

    in

    @rcd

    wh@

    iho*

    well a individuls vho

    rcgdding

    of rulin life t sk

    eis,
    i!.
    6

    wh@

    palimls

    possible lt is

    r.npoEl rclatioNhip b.tw@ . pltidt's pain dd

    b inquiF lbout egd d.trdion ed

    ba

    psrids ftd

    10

    the

    of

    is

    or ir

    Eqtnol Bpond6

    indivjduals in

    who doL

    lben

    ro

    individu.k *Do rry

    i*isdng ny tnin lnsug! ny .y. hdl. Or lilcly io b. poor

    dtins

    &uriolly dffiibe

    6sin8 &d

    !e trai.d fm @. d

    b.i

    DN

    di.ty llt* e tbe

    .idts p.i! lEly

    of th6c

    @!ditiG.

    all pain ed

    Th

    tr.ma

    motios
    hadac!6

    !$r najdily of

    h.!dach. p.li@ts h.v.

    m.jm dcpGsion or dysthnia diaerosis;

    addilionsl p6ychiatric diagrosis Ncb

    abus. Dilen6ine

    tuy

    agonphobi4 peiic diso.do, PTSD ard

    q!!tios. Eipdts aec

    headlch is likc pl.yinS twmty

    mw sion

    d.iliLd qu6tim dd
    ftr di.gD6is

    9T6

    eith . pali@t

    badndB h!v.

    of

    ney patidt! h!rc

    cld ot

    sbstr.a

    thst

    infmlio!

    ona prodre @oud

    s)@pims wnich fal in lo

    oily

    t 4t.d; Hoe ond <b )oul'aE nad&h now bE


    do rh. hadr.lE Lrst, wha .lid yoD 6rlr dd.lop had.c}c rh ldiarl d.? hrbi|l [d
    |sdzrbl. p.tt@ .plliars

    fhily
    h@d

    de

    &d woit dtualim bay

    tt Ma, sur8.ry

    ditroltic!

    mud

    lo

    loss of

    with opqing

    ed

    b. prob.d, A tul D.dicl histsy FDbins lbort past

    cGciowgs, .y.

    closirs ofjas, sld tbe

    5.!e fq lbtbid

    qdin

    disase,

    tion

    *ill

    dclutlc

    smi! d inf.dioa

    cdl.d El.6,o Enceh.lcstm (EEG)

    mt t

    indioic ! DdnDdiob in th. bFla

    th.y

    b.

    duirg I hqdach.

    udqso
    in rh.

    tnc

    .A Ph)*icie nay

    bdh ed ! bnin tMor, dd

    clDddt ad.chd.A @DPl.l.

    or

    llnm,

    giv610

    s8adt

    siih hdn

    nlw

    pinpoid

    e inlon&l

    diagmstic looh in

    leim d olhd qioq di!.e


    tlE

    cT

    FDhlo

    dGity

    of ditrd@r

    diqDo6tic i6t3 .l@a wilh

    ed tuina,tion ddd

    ro

    dilc

    dr

    6ults

    dy Dediel
    10

    An urys

    hs

    or beliv thal he

    the
    a

    patidt vho v.ry ond

    chMjc SirB

    lhal oi8hl

    x-ny itua6 of
    of

    rislg

    tatisg lb. p.lidt


    lh.

    !ft.id ofr TMd or

    or Psychiatric

    p.lidts dedidl

    aourat diaFsis,
    is

    v6el

    ofheld.chc

    tlT<

    diagnosir. The fi6r $ep in

    @ndition b to .sl.bu!h

    diaFosis Dull be onveyd

    (!$

    s.s F!d@

    rb*

    wi0r MiSrlin, or

    otddd

    llit a pot6l vith uusud hed!.h6

    aU

    lnc

    b.

    bhin acriviq. EEC

    of

    pliiot !Ddt@

    l6t tuy

    A Blood

    whid mi8hl d@ . badid., A t61

    c.mt u$dly

    b6i! thrr dDw srndlm d wiatj@ h

    history

    e ofncdi.atiG .thi! nay b.

    tonostlphy (cT) or (MRI) scd. To dhrinsdsh, Iot ble.ding

    s @hpuld

    ssilrcd

    bur

    dairl pFblds

    rE in, sinB psblaa

    sSSel stronely 6al lh. tEliol hu hiSnin

    phFictl ad n.@logic.l
    to

    Day

    disde,

    He.d&hc

    ratndt b.gi6 wii!

    thd ilis is a biologi.al dtordr au!.d by alt ..d

    $edd

    bE. chdisry *ilh Mondlry

    ch&96, ed usually a h.redil.ty !tr dkr@itioE S.Daina n b h.lpirl

    th. spoe

    F@l

    d sreifc lirlis ,acov.

    sl..p prrrcnll' T6vel

    FtuEd

    @uia ald pBdiptior

    b6td

    individuis who

    int@i*, wh6
    'R.portcd lbar

    oic penla

    lif. if

    sy

    sffi

    ilruss

    ro h

    tIE

    to

    ()m

    b r.erndl

    is lhc

    &ft p!in"

    b.

    pM

    Ior or

    d e

    to

    Gd

    bis or

    s pljn bli.fr

    t.k6 wdy clilicie hu ston6 of

    Dlsjc

    th

    anitu& duing ih.

    m lMy

    scd

    iltdvid-

    nsilg

    such

    GeFh t!@ relhe baicptcrDlogtcil

    b.

    v6y ad ofth.

    do.l

    .lini6l pr.dicrd

    b. pqfcr in

    suc! individuals

    or ohil&m

    prcblm.

    6 @vhne !p

    inrtrumnld th8t the

    6ping 3tyl6, MMPI

    to

    a "Mytning wo

    of

    ho p6in paiiais p@mlity

    ond

    dtil

    hlE ey qial pow.r?

    ".lo tou

    wilh Fin p{ri6t! rnd

    s s'r honth!,

    psychopalhology. Stp 3 th@

    ndtal

    Cohbired MiSnire,

    of

    Tmio

    do p@.ly wilh hio fegl

    tbmal

    bio

    h.cl m rclaatioo

    doy

    sou

    halth

    prof*ional

    ql@trttig dd 6g!itjv. flcloB,

    b ona u!d. St@ 4 blsd or oDtrDl

    i d@lio$

    f.cdba* .rd

    hadrch. od thr

    ny

    If the

    for

    clbric

    pain Dd h@d!c!.

    {lninistald ir dlpllioi bais; @8!itiE b.bvior tlkdlx rcla:.li@ thfrpy


    fcd bact oi a @bbi@rion

    ti.

    ris ddy hding nld *t d.ry @ing" nndly

    patr prcblms aoin8 or th.n fif.; r.pon no


    had

    Both ov6

    hdacha

    lo r qudlion $.:h

    dEt

    I did rot have this

    tuking, @tlitr

    Doisc cielr.rle

    fibclioning within mDol liniis,

    'sFdira

    pl.!m@

    pafiols have

    suh

    tu prdipi|r.

    dDiBtion mli

    slatN

    thcy'oe

    GF.e

    hrv.

    lEli iEgula

    stimli bly .d a ni!96 ,SoE. D.dilios.

    o. @.[s, or olh6

    A bnef

    to

    qplain lo lb. oupl. thlt Hedrcne a.d Mignin ir pali@la,

    and

    @ ono povotcd by botutrsl cle86, cqlrin fo.ds rigeEs5 dising

    of D@r

    swing thm

    d@ting rh. cli6i about th. mture of MgEin &d

    p.l'ot!

    clMior. Irsqy
    who @

    is

    or bio

    .e.d.d fo.

    sig.ifi@dy deprEs.d,

    alonc, Son. Iom of C.B,T aind al

    d@ing

    tbc

    !.qEle

    dFiqFpdor

    to or

    of

    coelffir

    *!qld b.not ha.ficid


    tu

    tL Filn prBioa suiay ltd .4rt

    to

    0@ p.ti.di'

    c !ii6d{y

    eho

    io

    @ntd

    slut

    Fliol

    ofbio

    Bio

    ft.dh.d

    f..dbrd i!

    tily Dbriolosicd

    !
    ..dviri.t by Fovidins hfomdi@ $ou tld.

    wbich

    Fovidcd by Olion & N@bg ( l9E0),

    Fsn

    dqra..d

    .L{!ilid

    ! vry ur.tul djuadiw 0t6.py-lhc Doi rx.incl

    Eey p.i!

    i!la6ti6. I a!6dm

    d rdeliod

    bio f..d Dod

    llr

    !.tiviri6. I inslvB lh.

    of r

    iFa!..

    oy !*lniqE thid

    D..!ie

    doe! . 6atpid

    lo

    rh.

    dility

    of

    Dditd lb. p|ti@!

    EqolE 8sF.lly EMG (rrna rel.lo!i@) d stftp. 3tin t@F.te


    h&drtio o|t@!i!g tb. p.liat! thylioloSicd E pds whtd at lb6 Erryd b.d

    todily

    to

    {E

    .itha tlnougb

    Fti6! lsEdly

    low d.radi.8
    mw uu.lty |

    {y no!.L !a.id

    06

    ulcftl

    a[

    ttd ! Fliar will b. $lc

    tDugh

    IEul t!a

    tclliqE i!

    th.

    obnilcd wha . bio

    hiSld

    SoinS

    fd qdpl. &d@

    @!pn-loa

    !@id !y 3@!d bai! duils


    l'.'p.d

    .l .diorr Ddditr

    io

    lFw

    10

    tatrot ofiEdxr!.

    f..dhcl

    is

    *i!

    $d

    .!d Fi!,

    @ld

    d ha
    hold

    ODaiDd

    of

    nu.otd 3tcldri 1ry6

    h.l

    liLly

    to

    Fitr.

    b. h.bnd

    3 . iiodc

    wilh

    ciilq

    hadlclE p.riar!, Coglitivc bdrviG rhqr9y

    qmi..ti@

    of

    Dd.d+li !.lf lrtrdan

    M.fring

    lctivity

    l4d,

    tuadioDd

    Drlyri

    Thtu

    lt

    D.!ir of p.ir

    is

    It is

    bodily r..Eon .

    F@i& s . cliniqlly
    clidol inlrovqFl i.

    of !t!.

    cvid.t . 5!88rsc

    6dpt i! ih. tEhatl of

    Ndl, mPr.lBiw

    i@rFr.tc o8niriw t.l)eid tldryy

    i!

    . mFd@ivq DuIi

    dieipliidy p.in ne!dort Fognm. TlE onuhliE wigl|t


    rh.t EMC b,o f..db.d.

    d.

    th! ibyliolosicd f..db..r.

    conlol hj!

    *nhin O.

    8oG hiShd

    t@Frr@ i! Fphd

    lppaB b

    Bio fc.dbr.L Ga.cidly

    ta* elti.h

    q loE .!d d . visud Dodditv

    FiD!lG). 'Dmus!

    lqn

    (r

    D'nd di*iPlindt p.in clini6

    Flulid

    or bio

    li.d b.cl witb

    rqy enn *nh P.in Prlictt

    d$ u!.fu

    nd.gaFt

    ro

    &d

    dmie p.lial'! bdi.n

    la[Gtt plMitg is !

    inclld6 t da.ild @.lu.tio ofoE

    f.i! oopl.iot

    !d!$

    ognitivc, b.hrvioEl .nd phyriologiel tlspon!.

    dii6io4

    ass6sot

    ihe

    th.

    of

    p6tial'r @gnitioN irvolv.d o orlyrir of in o8liliE @B ard s.lf lrllsnhis.

    coitiE .t@ Ffq 1o DaladapriE !.nd of0inlira


    disbnd. TlEy

    llsud

    og.itivc
    syn@

    ffi

    hui!

    ro bad)

    ir lbn

    6 flulty

    tberpisr
    a

    or n

    tbey

    losic, $cb

    with

    to rb.

    u'stirrjc ed

    mint@d@ &d d@rb!ti@ of

    tqnDot. S.lf slardats lit!

    slfsrrrqrars @ inrd l didoc!s,

    b!E@t

    ba.n

    lyrld

    to

    nBi .l$ l@t fd di.holomu


    be in bcd

    thinbng a

    (pain

    thcy ditra

    ton

    r.aftst s@ Eddli!8t li.f

    a 0 will t|cE b. !Dl. to oloab.

    hjd 9.in l.vcl $cy should

    al low

    @sdly rcl.r.d

    sd cd intsfft

    lbe plin conDlsirr

    cishrdiig

    to be

    tnat

    |my

    lnis

    potial3

    Ftrbl@) rh.

    b.lie

    $.1 if

    the

    od mt pafomirg ey activiti6 .nd if thfr

    par ld.h &d ! f.ling gm4 ln.y slbuld tunction 6 if

    tbey had

    b6

    at

    p.in &e,

    !4 of srr6s in !rli@t's lifc, Rdy or the


    gdial's subjcriv. ed idioslmlic dFiae tb. clinidie slodd irqliG .bout
    religiou b.li.f!- Mery plin pdidttcliefn i! a pMidmol nm tu fd sn d lnar
    rhey hav. doN, or rh.r prarq .lonc shoutd b. $ffidot io .liDinal. lh.n pair olhd sil
    hdpin

    sbould

    @nily mine

    pGsiblc

    ro

    &y gral

    Dding

    h.ld by patiols 6d rh. th@ist is

    dditer

    .ndt

    h. rqud rh.i th. Ddtiat

    slinrud Fslanivc.

    trt

    m.iB

    ald

    retod thot th.y h.v. prsyd ed thc loin

    if scn bdi.f6

    Tbcihslpisrbw

    n thc

    hk

    tcrn

    &ga,lb.

    @4ist pith .hrcnic pain th! p...litioM DNt

    $.n i!ol.n6,

    pl6Ea!1.

    d6ll

    ie c|@ itd
    fllira

    in rh.

    thcy

    b.ein to

    disr

    la.l

    of

    f!iu,

    Airitual i$ws

    !
    d.p'wio.rd $. didy

    .ls aat mE
    the

    halor

    for

    timc wifi ! b.havidEl

    badachc

    !3iidi lo

    inIflct wiih olhh one agdi4 dd ino6. ilc momt of

    in rh.ir life tur

    dbpl. vis a Aidil

    ajoy. ftebult

    blark, .!d

    I.'

    l Eli8iou

    c@po!@|. On. of$e tsycrDbsilt prinary job is lo notivat


    red!@

    thy hav. a

    dat!.Iy

    of

    lb.y

    !rv.

    mt visit d 80 fo.

    thdpy lit. &y job b t dios job (h.r inrclc jusr

    3dlilg dE ns!1 hfomalol! ph@ &. ndlt uy, to

    the p&tidr fte

    in(fu

    lbc

    thalpisr D!.t t lch thc paiidi to bEat 1!. pdn d@Ki@ cyclo To

    dMr

    voluLry wort ed
    the

    cliab

    of tun in his
    in tbe

    thal

    T1'6. ttu8rMr
    of

    rcrtawrnilNs

    th

    losibility of doing

    to

    b. individually

    tllorld th@ @

    no

    bl.nkel

    per is a cohplx, trMphytiologic b.h.vionl dd

    pslrbologidl ph@omo. hB

    mbirarjon

    c.g. visii

    dd in@rpontion ofditrG@l tldpdtic i6luiqu6 sliled to

    A[ trdtbdt3 h!v.

    ncd.

    RaSrition

    prcge.

    lif.

    ld

    .hG

    1o

    lh. dd.loprndl of iMvativ. t@lD@l

    orc omplq

    rratbdr r..hniqc b n..dcd

    MPtiotr
    !o

    If

    Pr&8.

    p.it i, mpld, lha

    s@.nnly Ear paddts, b.bvid

    e tujor @nponots of norl of dE hultitod.l prc8tlG.


    lJ1). Il.rdoti.npy. Phma@thqrpy of MiSrltc My b. dividcd itio

    rhalpy mdlrodr

    tah6t *ilh ihgs


    lnrr hrrc sFj6.d ttmMlogic i6nity b biid !o ei.ir Foldin r6.tt6 8rd .lta
    i[ naft ddid: inflaM.lo.y !d vtslr plr'@ of Misninc .rd 3) ft. dlily e
    rbE typ6,

    of

    |)

    TtalDar

    with

    no

    3Deific A!d8ic, 2) Aon.

    6&

    pF@tiE mdietiou.

    sd a !spirn!. Ac.asjmpld d NSAIDS (Nllqa

    Comotr @lg6i6

    Sodiu) ond previdB rclicflo p.tiou pith B'gnit h..da.l'6, dtdially

    aly

    in rhc on c*.

    hc.drin cxtrr stragth sd3

    noddte MieFir. bad&Dd,

    the

    tjns

    lototial

    day bul

    ro

    rh.y

    lha.

    mli.

    in migr.irs if

    lg6i6

    such

    Midrin, Fioret

    tdd .dly ,Tha. @4Fuds

    qus. srlSdic roboqnd iflatd l@ oltd. su.b s m@

    vdy holptul ed

    ocd$Gor fouiim$ ano


    dosine oI

    suFior in t .lting nild lo

    NSAIDT CoDbimtion an

    ard Fiorinsl, als hav bdeficial

    lare

    10 be

    druS!, rotha

    h,

    ifLta

    il& iiue

    !6f. lo late for Milrainc atlacls lbat

    Ardg6ic rcboud k

    morc likly related

    thd to th. totd nmbd ofdosB tttlt

    may b.

    b n q@t

    trLa sally in

    1.5.41. NSAIDS: Th.y

    6pond.d

    !o NSAIDS in ibe

    pdl done th6.

    did.G di* fd dpin!, ibuPrcfdr

    na}rcx@ sodim,

    tolf@ic eid

    atlcls, including sd@ !tt!.ts


    most

    @Bistot

    fBt lin tr. Eldt choie fd 3I DiSni!.

    ihc

    thai }avc

    ed ih. bbiEtim asE scamimpha

    @idilopbo

    @id Dd th. cmbirdioD ag@t

    plu apfi4 plN dfreine fd 0E @la ha[n@l of bjSEiE, TratJ!@t of @i.

    nigni*

    srr..](

    ZolnitriptrE,
    3i!e1945

    *s l@htidizcd h 1993 witlt $. irftd!.rio. of Smrlripl[s

    Nr.bipl4 ad Riatripl4 Ddihydfta8oidie

    a e inj4rior

    .fl*liv. b@e
    @.lor
    in

    and

    Pmtiw

    ndd

    sFay

    of lh.n sp6i6c

    i.tmpt

    I!*

    nigdift

    .a

    the

    diuC!

    Dlm.ologic atrnjty

    o'

    o Sfrrorir

    y th.

    1.5.43.

    orddinc

    bae.

    ftd

    tu

    (DHE)

    Opiod.

    lmariflm

    ofdus

    wirh

    rtk. F&r

    .vidff

    gmd

    did.@

    [oG dd

    |,il. dailt
    for lne

    Fqs

    Ls (c.8.

    on@

    ive

    d M@

    b.dicario

    .fdir4jB oftriprlr.,

    is good

    tu while pain is nild, (KaPpBl, Lu@,

    didae

    fo. lh

    e66f ed ef.ty of

    a !!)@lha.py fq !c!te nienin afi*L


    D.lg6i6

    oltd Ag@i' fd

    $8igsis thlt

    ro

    72

    E qDdt stE

    ocs

    @lrnitrjpt n. Irr@ d b@.fit of traling

    Bood

    and

    $frd

    di$blcd fd 48io

    alni fjpt

    Itrc

    n.sal srny.

    palials

    cheg.6 $at

    who

    .fiscy ofbutorph@l
    for

    vlsld

    and

    miolin (5lI

    p.doa

    satdpte ..d

    Opiods:

    bind lo cdlain

    bc tal@ dlny by

    Drgotrmird:

    dihyr!rc

    iltuS!

    tlkjng MAcbnibilon.

    higlily disbled nienine patimi with

    inF. sl

    ln*

    avril.bl.

    pllidL

    (tripld).

    nErripres, nzEipt{L

    10

    bs

    p.dot @ .LdaDnE if h. wislE

    aontsrs

    1.5.42.

    ,innmmalory

    e @i..i!dii.d

    lhie d fou) d n@ d lhd. *to


    ! mith-

    ws intidud in l9? .oI

    M chdi.d

    b.diqtioB D.y

    bd

    bm tlt@ n

    lh.

    wmiliiS triples

    alidctic

    aidor

    ody fo.

    tt.

    $lorrnoN dd int!.a$l

    oftlindicatd it pti@ts

    mctoclopmid; givo iltrav@oNly

    @y b!
    with

    s lpFlFilr

    Bug ed

    't.6.

    ie

    r8pds

    rh6py

    ro tbis

    not

    lh.

    prcee

    srDptonE Tb.

    pniort

    cpo@

    rdnory of

    dF{py dDuld b. limn

    thoughl to

    to lDd

    ud

    $. pmffl. of

    ldaie

    sacifc

    of

    d io @

    trshdr d)oi6 E!rt

    ll@ lhu fio rin6 F

    wcc}

    hdbch. (or drug iduc.d hc.d.ch.) medicitid ov6

    Eult Eob AqBl u.

    Aquacy

    cdinirg @!(htios $ch a hdn disde

    pEgtucy d'd u@nllllcd htFntuid tuy limit

    oedidl ovd

    on tbe

    .nd de@ oflarpoE y dis.bility .rd

    mediotion should als b. @nsid6ed

    etc

    Pltiots

    rlwtF Fldidlbl. bdivi.ludiz.d

    inporrdl. Tl'. choia of rr.tndt shodd b. b8.d

    edity of.rbct,

    rhd

    anack p3ni@laly in

    v@iliD8.

    Sire pltiar

    Miat.d

    s momtb@py fd @le

    otfr.tb.,u.

    Cro@

    n&agsDot

    cboi@

    prt n

    of aolc icdicltion @d ba .

    suggBls

    gltd .8.i.n

    1o

    hadach. i3

    of

    inMitS

    .tad.ch. fiql|@y, on@ Buliilg i! daily bgdadc.


    Thc Btidalc

    i6dch ed

    fd wdcnikjng

    OG

    hedd&he wE ! ncle.t d

    P&isi6. nE

    lstsor

    giva du. .natim

    ln

    prMGludy @ Itc thft wa pNity or

    ia

    culMt clinidl ed Bdrch s.n'!8s in

    diagMis ard D&r8@aI

    ?rtinn

    ln. nad&h. tstiar

    thbugh dFnsive ed invsive prcc.dw lilc C,T.

    @@ery

    .nd nosr of th. P.Lislads @uld ill

    r.1. Se6 i, P.lite,i


    It

    ltb.lF D.ti6ts

    gc

    toD dodor

    sm MRI

    $h..q@0y

    traln4t

    lne

    @l

    ro do.1or

    which nost

    ba

    goi4

    olth. lio.

    Eoqital!'

    which is eith6 p.nially

    Fti61 dsrclop.d lold:@

    or

    b.neici.l

    lh.y Ld

    e
    or

    .ithd 3im pain

    o docb.ti4

    to ESould,

    lhc 6ymptott.

    ri 6

    bdpnt for a brief Pdiod,

    dorc !o l@k into ih. unddlying I6yctFpdoloe/, lite Atui.ty

    @y b. qusn& Mirtlining

    bad

    !ffod.

    ha gpE.lty b@ obwed th.r hadd.h. pafa18

    or symprmatic

    tu

    of

    Bada.! &d linl.

    d d.pE3ion

    whjch

    Hadacb6 baing tbe orgeic badachB

    @.tion

    !o .lfinable

    psychologiql

    ihpdrdr

    Io

    dorl.

    v@u

    lEt

    rhe

    . r.WFydDlogicd

    tbey b.ve

    . r@bd of

    body

    E ir. e.

    Tl@ ws rc.d

    6. 6'1mn6l

    m6r of thc

    dis.e,

    m Propd

    gdng

    ir

    do nol

    sid

    ()M

    m1c

    strss

    mo

    i!

    lnologic.l pqetive. h

    ro

    .!ls

    utiliz. Fychologictl

    1o

    phFical
    .

    p.nnaai, liL b.IDvid, ioagdt. Dngs

    .ligm61 dplsing fdily dlMics\ dw.ting sieni66t

    psycboprlhologiq bddlying h.rd&hc!


    on. of

    h.l9; it is

    vbol. psriar Il i! . Dultj ld.L4 nulti lltsed Fobld ohjch

    qqdsc @gnjlidl. di.l'


    if l..tins

    a cry for

    m Dulti d.tmircd tb.y

    They

    ,q!i6 inrdddd .ds


    dn6

    lt js

    onplri

    to

    th.y @uld b. b.tta

    ard

    th. ho.r

    one of

    tuag@t

    30

    intdotiou,

    mdast&d th.

    Mad.

    i.vdirbly s d o@npdyine symptm in

    pFdordd d,snD.ridal di$rda

    @iqs d h6d!.,18 clid. i! P8i&ta Ths!

    !I q. , Aosi.a

    Hedrchq @

    E!eL!4 ndy, C@.!y dn

    is

    ba th@

    @. lgEh

    Wiudia bo*ffi, 6a!

    .fidiw cdFlhojE cli.i6 d i alid i. rhi.@


    Expci@3 of pain e ditr@t

    @mon liti6, th6 ws

    a$s@r

    cdtw.

    3pei6e ro ou

    swet ws

    in

    difrdor @lnB

    reslli.

    n.d ro deelop &d

    @nductd in

    sdie!

    dEugh rh@ @

    toob wnicn

    odd

    carlit

    aid

    Holpii.l ir ahjch sp@3li$ n@

    ed

    ditrmi

    6cld. like pslrhiatry pdi3lri6 olhthalholo&/, E.N.T. Aapucture, dediciE w@

    intdiewsd r.s&dins he5daclc


    hir spocidly

    frlgnat

    sl6mal

    &d ic

    o.*qm w* @gqMr

    d. Ey.

    of

    ha&.lE ws

    sFislisr $id rhrl EE dion .rd

    Pcdi.r.icid str63d @nrol ol

    C.T.

    *d

    fad rld proF f..ding

    n.dical sFci,lin @pnaved blood, ald uinc

    dd sinus rcd lo

    h@gsn6t

    t6 @

    lhst

    sFre .@rdiae io

    tur @beivc but

    ncds to be

    ..ds ro b

    xMiulior

    ot Plychiarn$ f.[

    Eacn

    6i.d

    6id

    our

    o!1 rh

    E-N.T. sEsed that thnal

    miety &d

    depression necd

    lo

    b.

    &tjr6sl

    Tbc

    @Nllart eid

    cliniql psrdologisl fccl dut @ntrids n.ds

    lhar

    fod ir
    All fcll

    OG

    for

    lad.cbe

    b. 3linul6td ald io

    should

    thlt

    ws a n.Sl.d.d @4 6cl|

    sss6t ms.g@6t

    Aagoar.d. Blt .ll f.li ihat hadachc ws

    olld e@uncrcd lhk prcblo

    s udGleding .!d

    in lhc

    of

    iadacnd wd

    6e

    dld@/clitic.t

    ea

    sdine

    dpqlise in this @, This would

    dd .hG!

    difdl .Ppd.lE ioto @ @nprhadE

    fosine in this d
    Ihe

    rnd nsy hclp in th.

    The

    ftdina oflhc

    bd

    di4

    of

    "nd

    lo h!rc

    6mF[6ivc p&k.8.

    whi.n

    psfchoth6.p, dioptrctic,

    .mlogi3t! i! in
    studid,

    |grcLa

    nc.d io

    dNlop

    @hd's
    itlqni.d .pPNch

    tu

    belP

    in

    O.

    Sdi6

    Hospiid,

    Crvc@ot

    mor

    ihPlisli$

    effetiv.

    r.y

    bc

    ttd

    mv

    m48ddt of

    e. ddive ed lnddleding

    tu pah Eduction on

    of

    .blc io d.v.lop

    ditr@t

    i|Mlv. diff.dr rhopy litc .olpun rlrq Eih,

    @ial tb6!py, phytioth@ly

    slinulstioA !'pnosh, sonopurw,


    hadsch..

    s.ssot ed

    6tlbulhmal oflb. sllrc of 0E .n @rd for

    sodd h.E positilc clini..l

    reldet

    rh@Fdic nod.liti6, .ftariv.

    of

    ln.

    lut

    @h6iv.

    sysld. Thc nudv wdd

    apFDvcd by th. Pujdb

    @.rh

    h.lp docrors, psychothdlpists

    hodach6. FrcD !

    i.

    bt oh speidty

    ltd f.ll lh.

    h..daclE clinic in lh. dcr{rtndt ofpsyd,irEy,

    ihe prcjccl hB

    6elgd6t

    not

    61lblktlDal of! p.in cliric, A 3t p ir lhis dir.rio

    dt blidDdt ofih.
    rjhoe ad

    lo

    ws tnn ttc

    a$de

    fd h.tpirg th. hadad. pari6ts. Il is inpotul

    Thc poin

    chi (which

    wilhoui prop.r

    l6dd

    c.pability

    hsdahB

    csllllt

    sFt @ding

    n.gl.ci.d

    ovdidilg tuiivsrid fd uddrlE

    Tbe

    telvcd

    Maidiu Cbqel) ed Ac!F.3sw of0E srlp.

    [dd..!!

    @@|!6H wd

    b.

    iij.ctions 6d nde bl@k! lhodd b! eiva- Tltt Aopu.tEisi felr

    Aclpuetu. poitu
    lh3life

    !o

    vi$tl im84y tld

    R4al admq

    in thb

    hnsI'ma .letricil

    obove

    dl pnyd ir fie

    diiddd Fovide hop. &d

    oflimi$!.Sd.nl typ6 ofothel int@otio w.ll int gBld ed delverd udd

    Thc ovdiding notiv.tion for

    udcn.king

    thc

    carch ea thli

    oi6 dcoutd.d tb. probld ir lhc irdo@ Dd ouido6 .!d


    ad uid1lrding dd exDdri$ ir Oi

    hdd!.i.

    for h.tping lhe

    Ois

    pati6rs. To dcv.lop

    tb.

    onc

    llschd

    felt ln rcd to decloP

    muu dn[@ 6e

    eEdng i$smais

    lMdd aFbilitt
    enicn

    @1

    ihblgh lhc grs sort .nd r.[ ln. doctdr *h@ th. Fir l)ltrs how d.6ilii,tit8 il n
    vhai olh6 facid $ch

    spoDd beft6

    to &ug

    s strs b.y

    siies

    nlugsnot lbdPy

    conolbidiiy in hada.h6

    p6tlhi.njlr il ba

    b. contributi4 !o

    $ rbll do<toB wil

    tnd gd th

    ona nildi.stoFd

    or

    io

    trsstot nd rin.,

    da

    $ee61d lh.t @ndbidity viih OCD n

    bc ablc

    n8leld by

    .&

    to

    Pl]m

    clinical

    ow & low6 nndiodn& (suo d .1, 2005). Tb. F6dt sn dy d$ litr lo lddr*
    l,h. ils ofoootbrdity in he&c!d. Thir *ill h.lp in rh. t<da udalmdi!8 oflh.
    ill.d which night lad to inFov.d dEFIi.
    Kling in vid the abov., ed rh. r66t!h di.d oll Nud th. wotld on
    vdi.ty of hcadac,lE, lhe prel intiiStdor i! b$.d on a !di6 of slDdi6 *hich v@
    6ied our wirh rhe following obj.divd r
    l, To idotry lhe bdrlying Fldop.thologi6 ofhdda.hc such s di*y,
    @nvcioq Ohwi @npulsiE dilordo, &pasion ed phoSia
    cliricrl *ding Bine ihc CreM ed CtuP

    2, D4lopbar

    of

    ! H@d&h. Q!.dioMiE

    pdidts wilh a wid. tuC.

    3,

    To

    ddalop

    EtFi.

    of n

    .dsi6

    ed

    (HQ)
    10

    Plin Qu6tioMirc whjci would

    cvalu.tiv. 6d o8lliive

    fd

    in

    t[. Plkist ni

    isl Indd (CCEI).

    in clid@l sdri4s with

    .jd . diffddtial di.enosis-

    n*e

    @pondi., Sine th@

    p.in in sqFry atr .tivc,

    wG rc

    pri n6sri4 ddi@

    lwil.ble {hd

    th sbdy w.s iDitiaLd, a prin

    Qu6tiomirc (MPQ) wa t6slai.d

    4.

    To 6r.blish lhe reliabiliiy

    Mc Gill Pain

    5,

    To

    ofiln p6ycbon.ric prcpdri6 ofihe

    r6rs ro

    '!s

    rtrld rh& fGing ojun

    uriliz.d ir clidcal sttirg @

    6, Dd.loPllol

    of

    h6d&t.

    di.ty (wt|rl.E

    th.6tity ofd.pBio4

    !@61.-

    rnd validatcd for ue in clinic,l eninss.


    ad.prd

    v6ion

    of rh.

    Q'6tio@ir (!fQ).

    fomdt prcrlnlt

    lal

    plotool (inst@dt) Mc Cill P.ir

    Flholoe,

    tuy

    .liri.id

    D..d io

    t6*d m p|ri6!3

    th. lrttrplod of hd&h.).Ih. mDld b.

    p.ii6b

    . @mprchdsive

    wilh r fooe on rh.

    for il3

    cf6ti6s

    prolo@l d@npasins nultinod.l

    i d@tio! to

    b. uscd in ihe .linic.l srudy .nd sdtings

    ?.

    To pmvid. a

    cdpais

    '

    sud

    $!rd b6is for IreE!@! wid@ bd.d sulll wft.quiFd 6. ih.

    of speific pb,']'relogj@l (dorF) ald

    M phm@logiel rrEtlat3

    s Fyclolhr4, da.doo, pl@)o, &d FrprnciG

    8. A mjd objedir .Dd puF{.


    rhdlFlric

    in'datjd

    i!

    t.

    9. Codud U. 6t!t .q Btuch

    olthc crdy wG th. dEloptjmt ofoinrall,

    EMgdGn

    of

    h6di.I6.

    in thi! &.r, r. th. fndings ofll se{rch woutd b.

    us.tul for clinical sttings to Fbvida did@a ba.d nnoale for moF

    hMgddt

    b.*d

    ofn.ad&he by eocral

    .tr ctiv.

    pd.tidhaq clirical pstcholoAist,

    psyclDlhftlist &d llmlogists.

    r.E" obj..n$ ofdt Pr&ntsttdr


    FollNins obj6tiv6 w@ fomular.d for dc

    l- ldotit

    th. Elddlyirg p6ycl'oFthologi6

    i. MigniB $d TGio. hadlcl* plri6ts.

    onnnly relddl &d rdi.hl. plir

    2.

    D.v.lopnai

    3,

    Id6li6elim ofladadB

    of a

    srdri

    and thcn

    NNal

    lml.

    pah inttuiris usirs the prol@ls dd.loD.d for

    4.

    Thdp.ulic outiMe uing

    5. To

    previ&didaet !.d

    In

    i!i!

    Halltct

    study,

    DruSA DtuF

    +Thdpv o Th.t4v' *Licb b$ Nsr

    DlioML for.fcdirc

    h.rdlclF qu6tio@it w3 d@.loP.d,

    Ot aioNeitut lr

    i.,20 itar qlcaiotridhi.! wa od8indlv

    dwelop.d in Misssiplr by Ab.l

    pised b A.lboy $ii

    od Lm (19?0) it th. 6ly

    s ted.t

    ir Urd!

    by

    Christi$ Coll.g.nd. Cliuiql Psychologj$ it

    qu6lid.irc

    Fsdl,

    ri6t6ot

    wN dv.lop.d ir

    f&nily,

    &

    *lia

    Eutllror .

    r9?0s

    dd n

    ?rcfsr

    of Fotru

    Urdu d@llegulgcin |95 th.

    Pilot snrdy .ih. qudtiom.irc @vs.d

    @itil, d!donrl, @lpximd .id do

    $i.l

    tinory .nd

    p@iou ndicsj ad pry.hi.Eic hidoty,

    t:
    lll, sftdy 2r
    lI0.

    Srudt

    PrycroD.6o!.eiq i!

    Dd.loDmlr

    Mtdi!. !.1T6.im Ead!.[6.

    of ah. T@l

    ud R.llrbltry .hdy

    Prd. i: !) Developnat ofa !d! qu*tioMire.


    b)

    DqEIoPttraI of

    irdie@u iDsuals {d

    t@ls io

    b.

    ued in lhc nain 3tudy.

    Pra, 2.Dcr@in d6
    1.12,

    studt3:

    of Eli.biliry of lhc &v.lop.d

    D.EloDdor oft!. frcroeh for !D

    !ffidt
    otr l&9. orle
    Pt6? ,:

    ln

    clbiol s.iingt

    6d mcasllm@t of bad&hc

    Prd.rj A$6motof cmp@iivc.ffclcy


    thorratjc itrtd@rioB s m6u.d
    pret@ls ovd a six wet irLn iw

    ituEd6t!.

    udnS

    prct@ls

    of vdious

    by Fe

    dd pon

    ts66t

    Fiod.

    llffidl

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