breaking up is painful …

… Kross et. al. in “Social rejection shares somatosensory representations with physical pain” use functional MRI to show that “rejection [recent break-up of a relationship] and physical pain are similar not only in that they are both distressing—they share a common somatosensory representation as well.”

Pain is what the patient says it is … but all “pain” is not necessarily mu-opioid receptor mediated … i.e. will respond to just cranking up the morphine. Most pain has components of psychological, social and spiritual factors … in addition to the physical … and needs to be addressed in a multi-disciplinary, holistic approach.

Classic resources for multi-dimensional pain assessment & mgmt …

Strasser etal. Palliative Pain Mgmt. Journal of Palliative Care; Summer 2005; 21, 2; p. 69.

Robinson and Bruera. Mgmt of Pain in Patients with Advanced Cancer. Journal of Palliative Care. 1995; 11, 4: p. 51.