Psychological approaches to chronic pain management: part 1

Adams, Nicola; Poole, Helen; Richardson, Cliff

doi:10.1111/j.1365-2702.2006.01304.x

Cited by 58 publications

(41 citation statements)

References 69 publications

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“…Most other studies have identified that chronic pain is associated with increased prevalence of depression and/or depressive mood; for reference see (16). In contrast to these results, Sullivan et al (36) found no correlation between pain and BDI.…”

Section: Inter-relationships Between Different Types Of Symptomscontrasting

confidence: 46%

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Generalized pain is associated with more negative consequences than local or regional pain: A study of chronic whiplash-associated disorders

Peolsson

Börsbo²,

Gerdle

2007

J Rehabil Med

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Objective:The main aims of this study were: (i) to determine, for chronic whiplash-associated disorders, whether widespread pain has more severe consequences for other symptoms and different aspects of perceived health than does local/regional pain; (ii) to investigate whether pain, depression, and symptoms not directly related to pain are intercorrelated and to what extent these symptoms correlate with catastrophizing according to the Coping Strategy Questionnaire. Design: Descriptive cross-sectional study. Patients: A total of 275 consecutive chronic pain patients with whiplash-associated disorders who were referred to a university hospital. Methods: Background history, Beck Depression Inventory, Coping Strategy Questionnaire, Life Satisfaction Checklist, the SF-36 Health Survey and EuroQol were used to collect data. Results: Spreading of pain was associated with negative consequences with respect to pain intensity and prevalence of other symptoms, life satisfaction/quality and general health. The subjects differ with respect to the presence of symptoms not directly related to pain. A minor part of the variation in Back Depression Inventory was explained by direct aspects of pain, indicating that, to some extent, generalization of pain is related to catastrophizing thoughts. Conclusion: Widespread pain was associated with negative consequences with respect to pain intensity, prevalence of other symptoms including depressive symptoms, some aspects of coping, life satisfaction and general health.

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Section: Inter-relationships Between Different Types Of Symptomscontrasting

confidence: 46%

“…A high prevalence of depression is found in individuals with chronic pain and is reported to be associated with higher levels of pain and disability (for references see (16)). Depressed patients appear to be more prone to use passive strategies than non-depressive patients (17).…”

Section: Introductionmentioning

confidence: 99%

Generalized pain is associated with more negative consequences than local or regional pain: A study of chronic whiplash-associated disorders

Peolsson

Börsbo²,

Gerdle

2007

J Rehabil Med

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“…The results of the data complemented the conclusions of the National Institute of Health's (NIH) panel (1995) and others (Adams et al 2006;Osborne et al 2006) that found strong evidence for the use of cognitive-behavioral techniques, relaxation techniques and hypnosis in reducing and alleviating pain. The reported decrease of intensity and frequency of subjective pain experiences and increase in functional and coping skills in this study coincide with results of other studies of psychological interventions for chronic pain (Caudill 1995;Osborne et al 2006;Roelofs et al 2002;Secor et al 2004).…”

Section: Discussionsupporting

confidence: 79%

Paining Out: An Integrative Pain Therapy Model

Pavlek

2007

Clin Soc Work J

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This article describes and evaluates an integrative pain therapy model as a beneficial form of painmanagement for chronic pain. The author based his model on cognitive-behavioral modalities, progressive relaxation combined with art therapy, sensory awareness combined with indirect clinical hypnosis, formal clinical hypnosis and self-hypnosis. Those techniques were applied in small group settings to systematically alter pain perception, pain interpretations and response to pain for the group participants' benefit. As a result, the group participants gained a greater sense of control over the pain, eased or abolished the pain, and decreased the stress, anxiety and depression associated with chronic pain. The techniques used were synthesized into ten group therapy sessions. A small data sample suggests that the model has clinical utility and maintained its benefits in a 6-to12-month follow-up.

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“…This highlights the fact that more effort must be invested in ''getting it right in the first place'', perhaps starting with better patient selection; the emerging evidence-base on predictors of poor outcome should assist in this respect [1]. In the meantime, the provision of better education regarding the likely outcome of surgery should at least lead to better informed, and hence more satisfied patients [33], whilst pain management based on cognitive-behavioural principles might be considered for those with chronic persistent problems [2].…”

Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of post-operative rehabilitation after surgical decompression of the lumbar spine

et al. 2007

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Spinal decompression is the most common type of spinal surgery carried out in the older patient, and is being performed with increasing frequency. Physiotherapy (rehabilitation) is often prescribed after surgery, although its benefits compared with no formal rehabilitation have yet to be demonstrated in randomised control trials. The aim of this randomised controlled trial was to examine the effects on outcome up to 2 years after spinal decompression surgery of two types of postoperative physiotherapy compared with no postoperative therapy (self-management). Hundred and fifty-nine patients (100 men, 59 women; 65 ± 11 years) undergoing decompression surgery for spinal stenosis/herniated disc were randomised to one of the following programmes beginning 2 months post-op: recommended to ''keep active'' (CONTROL; n = 54); physiotherapy, spine stabilisation exercises (PT-StabEx; n = 56); physiotherapy, mixed techniques (PT-Mixed; n = 49). Both PT programmes involved 2 · 30 min sessions/week for up to 12 weeks, with home exercises. Pain intensity (0-10 graphic rating scale, for back and leg pain separately) and self-rated disability (Roland Morris) were assessed before surgery, before and after the rehabilitation phase (approx. 2 and 5 months post-op), and at 12 and 24 months after the operation. 'Intention to treat' analyses were used. At 24 months, 151 patients returned questionnaires (effective return rate, excluding 4 deaths, 97%).Significant reductions in leg and back pain and self-rated disability were recorded after surgery (P < 0.05). Pain showed no further changes in any group up to 24 months later, whereas disability declined further during the ''rehabilitation'' phase (P < 0.05) then stabilised, but with no significant group differences. 12 weeks of post-operative physiotherapy did not influence the course of change in pain or disability up to 24 months after decompression surgery. Advising patients to keep active by carrying out the type of physical activities that they most enjoy appears to be just as good as administering a supervised rehabilitation program, and at no cost to the health-care provider.

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Psychological approaches to chronic pain management: part 1

Abstract: The application of psychological approaches to chronic pain management is reviewed and discussed. The way in which psychological approaches may be integrated specifically into nursing management of chronic pain is discussed in a later paper.

Cited by 58 publications

References 69 publications

Generalized pain is associated with more negative consequences than local or regional pain: A study of chronic whiplash-associated disorders

Generalized pain is associated with more negative consequences than local or regional pain: A study of chronic whiplash-associated disorders

Paining Out: An Integrative Pain Therapy Model

A randomised controlled trial of post-operative rehabilitation after surgical decompression of the lumbar spine

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