Disability, Chronic Pain, and Medically Unexplained Symptoms

Abstract

The concept of disability (including the WHO definition). Case example: disability cf ‘challenge’. Chronic pain, chronic fatigue, and spina bifida, Author’s keynote speech to New Zealand Disability Support Network. The experience of 100 people with different disabilities: system failure and ‘all some doctors see is my disability’. Author’s personal experience of disability resulting from osteoarthritis in both hips. Effect of aquajogging and gentle walking in easing pain, losing weight, and lifting mood. The experience of pain. Chronic pain syndrome and Professor Clifford Woolf’s (Harvard Medical School) 1983 definition of central sensitization. The role of the brain in the experience of pain. Central sensitization and case examples of carpal tunnel syndrome and low back pain. Regional pain syndrome, pain medication and the patient’s expertise with gabapentin. Number needed to treat of gabapentin is 6–8. Effectiveness of paracetamol. Medically unexplained symptoms explained, the example of fibromyalgia, irritable bowel syndrome. The concept of ‘curing’ compared with ‘healing’. The concept of homeostasis. The WHO’s ICD-11 (2018) and the new overarching concept of bodily distress disorder.