Chronic Pain

By Lim, Vivian | Hong Kong Journal of Psychiatry, December 1, 2008 | Go to article overview

Chronic Pain


Lim, Vivian, Hong Kong Journal of Psychiatry


Chronic Pain (In the series: Advances in Psychotherapy, Evidence-Based Practice - Vol. 11) Beverly J. Field, Robert A Swarm Hogrefe, 2008 US$24.95; pp112; ISBN: 978-0-88937-320-4

In western countries, chronic pain prevalence estimates in the general population range from 10 to 55%. Approximately 70 million Americans report chronic pain, with 10% having pain for more than 100 days per year. Chronic pain imposes tremendous costs on patients, employers, and the health care system. The American Productivity Audit estimated that 13% of the work force lost productive work time due to common pain conditions including headache, back pain, arthritis, and other musculoskeletal conditions, from August 2001 to July 2002.

Chronic Pain, written by 2 academics from the departments of anaesthesiology and psychiatry at the Washington University School of Medicine, St Louis, provides up-to-date information for those of us who have been overlooked in the management of pain. In traditional attempts to look for pathology and to treat symptoms, the role of psychology is often underestimated. Any chronic pain is best treated with a patient-focused and integrated approach.

From a clinical perspective, it is useful to classify pain: acute or chronic, nociceptive or neuropathic. While acute pain is usually associated with tissue damage, chronic pain is a result of complex systems. It is better understood as the integration of biomedical and physiological processes. Psychological factors play an important role in sustaining pain perception and coping. Chronic pain leads to a vicious cycle of depression, helplessness, guilt, and increased preoccupation with pain. It is accompanied by a multitude of negative behavioural responses like restricted activity, sleep deprivation, and social withdrawal. Misuse of opioid analgesics and alcohol complicate patients' problematic behaviours. Patients with chronic pain often resist referral to mental health professionals. By the time they present to mental health services, many have already seen a number of physicians, some of whom may have implied that the pain is purely psychogenic. It can be challenging to establish a therapeutic alliance with patients who respond with defensiveness or hostility.

An overview and practice guides for the psychological evaluation of chronic pain are given in this book. The assessment should include: a careful review of the patient's medical records; exploration of the patient's beliefs, expectations, and negative cognitions related to pain; elicitation of symptoms of depression and anxiety; gauging of how well the patient and his / her family are adjusting to changes in family roles; elicitation of co-morbidities such as sleep disorders; and evaluation of the patient's coping skills. Because of the complexity and multidimensionality of pain, single-modality treatments are not as effective as multimodal approaches. Psychological therapy is rarely used as the sole treatment modality. It is usually combined with analgesic medications, behavioural or psychological therapies, physical therapies, injections, and interventional procedures. The goal of treatment, in most cases, is not to cure or 'fix' the pain, but to reduce the severity and improve function. The manner in which patients respond emotionally and behaviourally to pain varies, depending on individual characteristics and external resources. Individuals with broad coping-skill repertoires, flexible responses to adverse circumstances, and supportive families and friends may be able to make adaptive adjustments to living with pain. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Chronic Pain
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.