Pain management 1: psychological and social aspects of pain

Abstract

This two-part article presents psychological and social factors which affect pain perception and response and the implications of these for nursing practice. In this article, the complex interactions between neurophysiological and psychological factors are outlined and theories of pain perception and ways in which the pain experience can be modulated are presented. The role of psychological factors, attitudes, beliefs and expectations of both patient and practitioner, pain behaviours and ability to cope are discussed. In the second part, these are further elaborated with particular reference to the nurse-patient interaction. The use of psychological approaches to augment clinical practice, such as education, reduction of anxiety and improving coping ability, are suggested. Finally, the importance of communication skills in pain management is addressed.

What does coping mean to the worker with pain-related disability? A qualitative study

“…We have evidence that certain beliefs about pain (e.g. pessimism about recovery, the belief that work will make the pain problem worse) are associated with poorer recovery outcomes [57][58][59]. However, our understanding of these linkages is limited and questions remain.…”

Age Differences in the Correlates of Physical Functioning in Patients With Chronic Pain

“…They may also be more likely to attribute physical dysfunction to pain. Expectations are strong determinants of self-report responses (Adams & Field, 2001), and such effects could produce the observed pattern of results whereby pain-function relationships are stronger among the elderly. Finally, pain is more widespread, and comorbid conditions are more frequent with advancing age ).…”

How Does Myofascial Physical Therapy Attenuate Pain in Chronic Pelvic Pain Syndrome?

“…ere are subgroups of CPPS including provoked vestibulodynia (PVD) referred to pain provoked by touch or during vaginal intercourse (dyspareunia) [15,16] and painful bladder syndrome (PBS) characterized by pelvic pain and urinary storage symptoms (e.g., persistent urge to void, nocturia, and urinary frequency) [17,18]. CPPS women also characterize by dysfunctional pain system as expressed by hypersensitivity of the peripheral and central pain systems, as well as dysfunctional pain modulation [3,[19][20][21][22] as well as psychological distress [23,24], manifested as high levels of anxiety, pain catastrophizing, depression, and somatization [22,[25][26][27][28][29][30][31][32][33]. All these factors and the interplay between them may affect the severity of symptoms presented by chronic pain patients such as those with CPPS [34][35][36].…”