Psychology of Pain

Price, Julie R.; Price, Micah J.; Huntoon, Marc A.

doi:10.1093/med/9780190217518.003.0004

Oxford Medicine Online 2017

DOI: 10.1093/med/9780190217518.003.0004

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Psychology of Pain

Julie R. Price¹,

Micah J. Price²,

Marc A. Huntoon³

Abstract: The role of psychosocial variables in the understanding, diagnosis, and treatment of pain has grown significantly in the past 30 years. Pain is no longer dichotomously thought of as either a purely psychological or physiological condition (mind–body dualism) but, rather, as a combination of biopsychosocial factors and experiences. The questions in this chapter consider the changing role of these psychosocial factors by exploring the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and… Show more

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2020

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Couple Therapy Based on Mindfulness to Improve the Satisfaction of Life and Pain Self-Efficacy in Patients with Chronic Pain.

Firoozi¹,

Rouhi²

2020

TOPAINJ

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Background: To manage chronic pain, in addition to medical interventions, several psychological treatments have been designed. In couple therapy based on mindfulness, in addition to the patients, their spouses, who care for the patients, were involved. The purpose of this research was to study the effectiveness of couple therapy based on mindfulness to improve life satisfaction and pain self-efficacy in patients with chronic pain. Methods: The present study is a quasi-experimental and clinical trial with a control group with pre-test and post-test. The research was performed at LABAFI NEJAD Hospital in Tehran on 30 patients with chronic pain and their spouses. To measure the efficacy of treatment, a short form of self-reported Pain Self-Efficacy Questionnaire (PSEQ) and the questionnaire of life satisfaction (SWLS) were utilized. Results: The results showed that the level of pain self-efficacy after the intervention in the experimental group increased, while in the control group, this value remained unchanged. Also, the intervention has improved the satisfaction of life among patients in the experimental group. Conclusion: Couple therapy based on mindfulness, an eclectic intervention, can increase social support, improve the quality of sex, and decentralize pain. Additionally, paying attention to neglected caregivers, and patients with chronic pain can rise pain self-efficacy, and life satisfaction. Finally, suggestions for future research are offered.

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Couple Therapy Based on Mindfulness to Improve the Satisfaction of Life and Pain Self-Efficacy in Patients with Chronic Pain.

Firoozi¹,

Rouhi²

2020

TOPAINJ

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How do high preoperative pain scores impact the clinical course and outcomes for patients undergoing lumbar microdiscectomy?

Virk

Vaishnav

Mok

et al. 2020

Journal of Neurosurgery: Spine

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OBJECTIVEPreoperative pain assessment is often used to gauge the amount of disability in patients with lumbar disc herniation. How high preoperative pain scores impact the clinical course and outcomes of patients after lumbar microdiscectomy is not always clear. Here, the authors aimed to determine whether patients reporting higher preoperative pain scores have worse outcomes after lumbar microdiscectomy than those reporting lower preoperative scores.METHODSThe authors performed a retrospective review of patients with symptomatic lumbar disc herniations that had failed to improve with nonsurgical methods and who had undergone tubular lumbar microdiscectomy. Health-related quality of life (HRQOL) scores had been collected in the preoperative and postoperative period. The anatomical severity of disease was graded based on lumbar disc health (Pfirrmann classification), facet degeneration, thecal sac cross-sectional area, and disc herniation grade. Data on each patient’s narcotic consumption and length of stay were collected. A Student t-test and chi-square test were used to compare patients with high preoperative pain scores (HP cohort) and those with lower preoperative scores (non-HP cohort).RESULTSOne hundred thirty-eight patients were included in this analysis. The 47 patients in the HP cohort had taken more preoperative opioids (12.0 ± 21.2 vs 3.6 ± 11.1 morphine equivalent doses, p = 0.01). However, there was no statistically significant difference in Pfirrmann classification (p > 0.15), facet grade (p > 0.11), thecal sac cross-sectional area (p = 0.45), or disc herniation grade (p = 0.39) between the HP and non-HP cohorts. The latter cohort had statistically significant higher preoperative PROMIS scores (36.5 ± 7.0 vs 29.9 ± 6.4, p < 0.001), SF-12 mental component summary scores (48.7 ± 11.5 vs 38.9 ± 16.1, p < 0.001), and SF-12 physical component summary scores (PCS; 32.4 ± 8.6 vs 27.5 ± 10.0, p = 0.005), but a lower Oswestry Disability Index (56.4 ± 22.1 vs 35.4 ± 15.5, p < 0.001). There were only two time points after microdiscectomy when the HP cohort had worse HRQOL scores: at the 2-week follow-up for SF-12 PCS scores (32.4 ± 8.6 vs 29.3 ± 7.1, p = 0.03) and the 12-week follow-up for PROMIS scores (45.2 ± 9.5 vs 39.5 ± 7.1, p = 0.01). All other postoperative HRQOL measurements were similar between the two cohorts (p > 0.05).CONCLUSIONSA patient’s perceived severity of disease often does not correlate with the actual clinical pathology on imaging. Although patients who report high pain and have a symptomatic lumbar disc herniation may describe their pain as more extreme, they should be counseled that the outcomes of microdiscectomy are positive.

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Psychology of Pain

Cited by 2 publications

References 0 publications

Couple Therapy Based on Mindfulness to Improve the Satisfaction of Life and Pain Self-Efficacy in Patients with Chronic Pain.

Couple Therapy Based on Mindfulness to Improve the Satisfaction of Life and Pain Self-Efficacy in Patients with Chronic Pain.

How do high preoperative pain scores impact the clinical course and outcomes for patients undergoing lumbar microdiscectomy?

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