Dolor crónico y modificaciones de la conciencia corporal

This review article addresses the relationship between chronic pain and body awareness. Chronic pain refers to an ensemble of pain conditions whose common characteristic is the fact that peripheral lesions cannot explain the duration and intensity of the pain. The lack of explanation in terms of peripheral damage has led researchers to assume that the central nervous system plays a crucial role in these conditions. In particular, one suggestion about how such central factors might operate is by influencing patients’ body awareness. In the first part of this article I present evidence showing a bidirectional relationship between chronic pain and what might be called ‘exteroceptive’ body awareness, as well as the related hypothesis that pain results from a disruption in the mechanisms underlying exteroceptive body awareness. Next, I discuss some issues that this hypothesis fails to explain, and I consider the relationship between chronic pain and the autonomic nervous system. Finally, I relate this latter relationship to the notion of ‘interoceptive’ body awareness, and explore the idea that understanding the mechanisms that relate exteroceptive and interoceptive aspects of body awareness might shed light on the nature and development of chronic pain.