The psychology of chronic pain and its management

Abstract

A traditional biomedical perspective considers pain as a direct consequence of an underlying pathology. The French philosopher René Descartes was one of the first to describe pain using a mechanical model. In his model there are direct and unique pain pathways from the body to the brain, in the same way a bell in the church tower rings when the rope attached to it is pulled. For Descartes, pain was a reflex of the mind upon nociceptive stimulation of the body. Pain was treated as a symptom, isomorphically related to the severity of underlying pathology. According to this perspective, pain treatment mainly consists of two acts: localisation of the underlying pathology and removal of the pathology with appropriate remedy or cure. In the absence of bodily damage, the mind was assumed to be at fault, and a psychological pathology was inferred.Similar assumptions are found in the specificity theory of pain. This theory hypothesises specific receptors and nerves that unambiguously transmit information about tissue damage (nociception) to the specific areas in the brain. It is not surprising then that 'pain-receptors', 'pain-nerves' and 'pain-centres' are spoken of. The biomedical perspective has undoubtedly resulted in medical successes. However, it is now known that many observed phenomena are not in line with the specificity theory. First, there are no specific 'pain' receptors or 'pain' nerves. At most, there is specialisation: some receptors or peripheral nerves are more sensitive than others in the transmission of nociceptive information. Second, research has not been successful in locating specific pain centres in Pain is among the most common somatic complaints. Fortunately, in only a minority of people is pain long lasting and severe, such that it interferes with daily life activities. Those with chronic, disabling pain present to healthcare providers repeatedly. Often they experience anxiety and depression, irritation, frustration and helplessness, and they suffer from insomnia and excessive medication use. It is well known that this group of chronic sufferers is difficult to treat: there is no immediate and definitive solution available for their pain problem. Therefore, treatment objectives consist of learning to control the somatic complaints and to improve the quality of life. In this paper, the importance of cognitive and behavioural processes in the experience of chronic pain and in pain-associated disability are discussed. First, pain is viewed from a traditional perspective that assumes a direct and immediate relationship between tissue damage, pain experience and disability. Next, pain is considered within a biopsychosocial perspective. Implications for the treatment of patients with chronic pain problems are outlined. We summarise theoretically grounded and effective treatment strategies in patients with pain, and conclude with emergent themes for future research and the improvement of clinical practice.

The Relationship between coping Strategies, Perfectionism, Beliefs Pain and the Chronic Pain after Controlling the Age Effects in Firefighters

“…In addition, there was a negative significant correlation between problem-focused coping strategies, pain records, and chronic pain disorder severity. This finding was consistent with other research findings such as (Vlaeyen, Crombez, Goubert;. In order to clarify the above findings, it can be referred to the definition of coping by Vlaeyen, Crombez, and Goubert (2007) as an effort that one makes in order to adapt to a situation and to eliminate or reduce the stressful stimulus.…”

“…In the realm of pain, the aim of problem-focused coping strategies is to solve the problem of pain or prevent its increase. Studies on these strategies suggest that, they are helpful when used together (Vlaeyen, Crombez, Goubert;. Pain self-control and its effectiveness depend on unique ways through which the patient encounters with and adapts to pain in order to reduce or stop the helplessness caused by it.…”

A quality review of smartphone applications for the management of pain

“…Despite the extensive literature highlighting the importance of a bio-psychosocial approach to the management of pain conditions, 1,3 very few apps incorporated this component. A strong focus on pharmacological therapy and natural remedies was evident.…”

“…They can predict the person’s adjustment to living with pain and the extent of disability exacerbated. 1 The psychological side effects of persistent pain may lead to a cascade of psychological stressors. Consideration of social dimensions to chronic pain is important since pain can seriously affect the individual’s quality of life.…”

The effect of psychoeducational intervention, based on a self-regulation model on menstrual distress in adolescents: a protocol of a randomized controlled trial

“…Various studies have shown the efficacy of complementary and alternative therapies (e.g., herbal remedies [ 18 – 20 ], exercise [ 11 ], heat [ 21 , 22 ], and hypnosis [ 23 ]) at reducing menstrual pain. Cognitive behavioral therapy is one of the non-pharmacological treatments that can effectively relieve dysmenorrhea as psychological factors can exacerbate pain [ 24 ].…”