Dr. Zeltzer: Certainly, because of the mind-body connection, when pain becomes chronic, it recruits so many different parts of the body -- the mind, the emotions, and the neurochemistry -- that a multi-modal (meaning many different components) approach is needed to treat the pain and help the child be able to go back to school, sleep, and do other activities.

Dr. Bursch: I would like to emphasize what Dr. Zeltzer presented and underscore the importance of education.

Dr. Zeltzer: Many children coming to us have been placed on drugs, even some of the same drugs we might recommend, but without the other components and because of the mind-body connection, the various components must be addressed, otherwise the drugs alone will not be effective.

Dr. Bursch: Many people who have chronic pain spend much time, money, and energy attempting to find that part of their body that is broken, and while it's reasonable to have a thorough evaluation, often one's pain has been going on for a while. It is very difficult or impossible to find the source of that pain. As we've described, the reason for that is because it is a pain signaling issue that can go on, even if the initial reason for the pain has gone away. If you start to treat your pain without an understanding of this, you could spend a lot of time in search for the cause when you will never find one and, of course, be quite distressed in the meantime which can contribute to the pain itself. If you're spending a lot of time in the diagnostic part of this, then you might not be spending time on treatment and getting better. So cognitively understanding how the various systems interact to help pain continue long after the reason for pain has gone away can actually help somebody get better and refrain from causing themselves more distress and more pain.

Moderator: Doctors, as we near the end of our time, would you care to offer some closing remarks?

Dr. Joseph: I think I would like to reiterate the fact that your mind and your body do communicate with each other on an intimate basis. Your mind is your body and your body is your mind. Those systems are not separate. When we are dealing with chronic illness or chronic pain, what has happened is a discommunication of those normally functioning pathways. Instead of mind and body being one, they become separated and it leads to chronic stress. By learning techniques and reintegrating healthy communication, that communication enables the body and person as a whole to heal and become healthy again.

Dr. Zeltzer: Certainly, I would like to provide the phone number for anybody who has a child with a chronic pain problem and would like further information about our pain clinic: It's UCLA, (310) 825 0731.

Dr. Zeltzer: Thank you, Brenda and Mike, for participating.

Dr. Joseph: Thank you, Dr. Zeltzer, for having us.

Dr. Bursch: Thank you.

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