Culture shapes human pain. Lesions, neurons, neu rotransmitters, and genes may provide a starting point for an exploration of pain's roots in animal models, but among humans, it is our culture as well as our biology that invariably shapes pain. Some may disagree. Disagreements about pain have a long history. And what is now called "pain medicine" has witnessed both open and covert hostility between partisans sometimes called peripheralists and centralists. Peripheralists take a lesion-centered view that pain requires continued input from the site of tissue damage, whereas centralists argue that pain can be maintained by psychological and social forces long after input from the peripheral nervous systems have ceased. Today, many pain clinics and programs in pain medicine take an integrative approach that is explicitly biopsychosocial. Although some researchers trust in a breakthrough that will fully account for human pain at the level of genes or neurons, there is growing agreement that humans construct pain not only through cellular mechanisms, but also through broader processes of culture.