Pain in its environmental context: Implications for designing environments to enhance pain control

Abstract

There has recently been heightened recognition that environmental factors can influence pain. Clinicians involved in delivering multidisciplinary pain programs often structure the social environment of their treatment settings to help promote adaptive responses to pain. Recent theories of pain (e.g. Craig, 2003, Melzack, 1999, Fields & Basbaum, 1999 highlight the role that sensory stimuli from the environment can play in influencing the pain experience.Despite the awareness if the environment's influence on pain, patients with pain continue to be treated in settings that are devoid of distracting stimuli. The typical treatment room is painted white, lacking decoration, sparsely furnished, and windowless. Patient's auditory stimuli may range from the noise generated by overhead lighting to urgent, loud paging requests, to sounds of other patients suffering. The visual and sensory settings in which we usually treat pain patients probably do little to relieve pain and may exacerbate pain. This paper considers the influence of environmental stimuli including light, nature scenes and sounds, and video and virtual reality (VR) stimuli on pain and examines the implications for designing pain treatment environments to enhance pain control. Literature Review LightLight is an integral part of any building and can vary according to time of day, location of the structure, window number and style, and numerous other structural and environmental elements. Light influences people in the building and available evidence suggests that exposure to light has implications for pain experiences. Walch et al. (2005) recently conducted a prospective study testing the effects of exposure to sunlight on pain medication in 89 patients who had undergone spine surgery. Patients were randomly assigned to a bright or dim room in the hospital. Bright rooms were exposed to 46% more natural light than dim rooms. Patients in the bright rooms required 22% less opioidequivalent analgesic medications which resulted in 21% decrease in medication costs. Bright room patients reported significantly greater decreases in stress and marginally significant decreases in pain. The fact that recovering in a room with more natural light lowered medication intake is noteworthy, particularly since lower medication intake is associated with fewer side effects and lower costs.Exposure to light may enhance recovery from painful medical conditions. Beauchemin and Hays (1998) conducted a retrospective study that examined the impact of natural light exposure Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers

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