PSYCHOSOCIAL TREATMENT OF PAIN

Pain is a complicated phenomenon. Every person experiences pain in a different manner, and it has become clear to many clinicians and researchers that the longer a person has pain, the more difficult and complex treatment needs to be. The type and intensity of discomfort varies depending on physical causes of the pain, the personal meaning it has in a person’s life, one’s social support and relationships, one’s general physical condition, and any psychological aspects that may be triggering or accentuating the condition.

Psychosocial interventions are an important part of treatment for many patients experiencing pain. This form of treatment ranges from supportive counseling (dealing with the feelings associated with having pain and the resulting physical and psychological complications), to active interventions designed to reduce pain or heal the conditions that are causing it. Examples of the latter include hypnotherapeutic approaches, which help patients reduce pain and the sense of being enslaved by it.

Most of the time, patients seeking psychosocial treatment are experiencing chronic pain or chronic pain syndrome. The next section provides information about several different forms of pain.

 

TYPES OF PAIN

Pain is generally divided into several categories. One common breakdown of pain types is shown below:

Acute - Acute pain is simply pain that comes and goes relatively quickly in about two weeks or less. Common examples include a simple burn, an infection, a scratch etc. The healing and pain time is usually about two weeks. In a nutshell, the person gets better quickly.

Subacute - Subacute pain is really acute pain that lasts a little longer—up to about three months. Common examples are a simple fractured bone, simple and temporary arthritis or joint swelling or even a prolonged infection. However, in the end the person gets better.

Chronic - Chronic pain is usually described as pain lasting more than three months. It can be inconsistent—increasing or decreasing in intensity and duration. The most important aspect of chronic pain is that it probably will not be "cured" unless the physical source of the pain is found and successfully treated. Some pain disorders cannot be completely fixed, and the person needs help from multiple medical and psychological service providers to "live with the problem."

Chronic Pain Syndrome - This is a condition that literally takes over a person’s life. It should be considered when pain...

• has been present for at least several months

• remains poorly localized

• occurs in the absence of any discernible pathologic process or appears disproportionate to that process

• remains unrelieved by routine clinical doses of standard analgesics, especially opioids

• is aggravated by surgical intervention

• is associated with observable changes in mood and behavior

• is linked to adverse psychosocial circumstances

• seems to serve no overtly useful purpose

• is often associated with gross limitation of function.

updated June 20, 2004

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