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hello everyone my name is Dan Clough Im a Rheumatologist here at U of M I lead a large pain research group and I give these talks every couple weeks to chronic pain patients their friends their family members to try to help people that have chronic pain better understand what we now think causes chronic pain what is some of the underlying causes their mechanisms for chronic pain are and even more so to try to give you a sense of the types of things that you can do as a patient to manage your own pain in a lot of other areas of Medicine we have been much more aggressive about trying to involve patients in their own management or in their own care conditions like diabetes would be good examples of for twenty years weve been teaching people about diet and exercise and things like that so that they really are involved in helping manage their illnesses and that really has crept into the management of most chronic medical illnesses except chronic pain we generally dont do a very good job