Authors’ reply to Bray

We thank Bray for emphasising the fundamental role of psychological factors in chronic pain.12 The definition of pain by the International Association for the Study of Pain has been recently revised from “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” to “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”3 The updated definition reduces the emphasis of pain needing to be associated with tissue damage, and the updated accompanying notes include “Pain is always a personal experience that is influenced to varying degrees by biological, psychological and social factors,” which further embraces the importance of mind-body interactions that, some may argue, have been previously overlooked.3Although a detailed exploration of psychological factors was beyond the scope of our brief review, we did mention the bidirectional relationship between psychological factors and…
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