Terapia del dolore / Pain therapy

Molte definizioni sono state date del fenomeno dolore ma nessuna completamente soddisfacente. La prima fu quella notissima, di Cartesio (1630): “Il dolore è un campanello d’allarme che avverte l’anima di un pericolo imminente”. Nelle mie lezioni di fisiopatologie e terapia del dolore dicevo agli studenti che “Il dolore è la presa di coscienza (avere la consapevolezza) di informazioni nocive che pervengono al cervello”. Oggi si usa molto la definizione ufficiale della IASP (International Association Study of Pain), riportata accanto nella versione originale in inglese.

Mario Tiengo

• • Il Centro Mario Tiengo, Medicina del Dolore, Policlinico, Milano, via Commenda 19: http://bit.ly/CentroMarioTiengoDolore

  • Il Padiglione Maria e Pier Ettore Bergamasco, via Commenda 19, Milano. Grazie ad una generosa donazione da parte della famiglia Visconti in memoria del dott. Pier Ettore Bergamasco, il Prof. Tiengo ha ristrutturato questo stabile e ci ha creato una delle prime cliniche per la terapia del dolore in Italia, diretto da lui fino al suo pensionamento nel 1992. La clinica, tutt'ora nel Padiglione Bergamasco, ora è intitolato "Centro Mario Tiengo ": http://bit.ly/BPavilionDolore

Many are the definitions that have been made of the phenomenon of pain, but none are completely satisfying. The first was the famous one of Descartes (1630): “Pain is an alarm bell warning the soul of an imminent danger.” In my lessons of the physiopathology and therapy of pain, I used to say to my students that “Pain is the awareness of, the consciousness of, nociceptive information arriving in the brain.” Today, the official definition sanctioned by IASP-International Association for the Study of Pain:

'An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Note: ... Pain is always subjective. ... It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience.... Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons. There is usually no way to distinguish their experience from that due to tissue damage if we take the subjective report. If they regard their experience as pain and if they report it in the same ways as pain caused by tissue damage, it should be accepted as pain. This definition avoids tying pain to the stimulus. Activity induced in the nociceptor and nociceptive pathways by a noxious stimulus is not pain, which is always a psychological state, even though we may well appreciate that pain most often has a proximate physical cause.'

"Part III: Pain Terms, A Current List with Definitions and Notes on Usage" (pp 209-214) Classification of Chronic Pain, Second Edition, IASP Task Force on Taxonomy, edited by H. Merskey and N. Bogduk, IASP Press, Seattle, © 1994

(http://www.iasp-pain.org/AM/Template.cfm?Section=Home&Template=/CM/HTMLDisplay.cfm&ContentID=3058)

Mario Tiengo (trans. S. Meyer)

• • The Mario Tiengo Center, Pain Medicine, Policlinico, Milan, Via Commenda 19 (link in Italian): http://bit.ly/CentroMarioTiengoDolore

  • The Maria and Pier Ettore Bergamasco Padiglion, via Commenda 19, Milan, Italy. Thanks to a generous donation on the part of the Visconti family in honor of the memory of dott. Pier Ettore Bergamasco, Prof. Tiengo had this building repaired and refurbished, and created there one of Italy's first pain clinics, which he directed until his retirement in 1992. The clinic, still in the Bergamasco Pavilion, now is entitled "Mario Tiengo Center," (link only in Italian, but with a photo): http://bit.ly/BPavilionDolore