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FOREWORD The purpose of this book is to bring together the exciting basic science research and describe my new law on the biochemical origin of pain. Sota Omoigui’s Law of Pain states that: The origin of all pain is inflammation and the inflammatory response. This is the most significant advance in our understanding of Pain since the 1965 publication of the Gate Theory of Pain by Canadian psychologist Ronald Melzack and British physiologist Patrick Wall. In their paper titled "Pain Mechanisms: A New Theory" [1] , Melzack and Wall suggested a gating mechanism within the spinal cord that closed in response to normal stimulation of the fast conducting "touch" nerve fibers; but opened when the slow conducting "pain" fibers transmitted a high volume and intensity of sensory signals. The gate could be closed again if these signals were countered by renewed stimulation of the large fibers. Sota Omoigui’s Law is a dramatic and revolutionary shift from a focus on structural pathology to an understanding of the biochemical origin of Pain. It ushers in a new age for the understanding and treatment of Persistent Pain. Pain is a complex disease. With this book, we hope to show the complexities in the origin of pain. The specialty of Pain Medicine is an art and science that requires fundamental biochemical knowledge by both doctor and enlightened patient. The understanding of my law will enable the knowledgeable physician apply various biochemical strategies at different times to treat and control pain. There is a foremost doctrine of military warfare whether conventional or asymmetric that states: No battle plan ever survived first contact with the enemy. In the battle against Pain, this doctrine is no less applicable. We must attack pain with different biochemical agents at varying points in time, and the physician must adjust the strategy to the patient, and what works for them. For example, inflammatory mediators generating a pain syndrome may vary in different people and even in the same person at different times. A therapeutic strategy may work for a while in a person and then cease to be effective. A good knowledge base is a prerequisite to altering the battle strategy and conquering pain. We must work to develop technology to enable non-invasive imaging of the biochemical mediators of inflammation. It is my hope that this law will light a candle in the darkness of our knowledge of Pain and will be a beacon of hope to all humanity. Sota Omoigui MD Hawthorne, California April 11th, 2002 |
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