When pain is chronic, psychological pain management is useless (I chose to disagree with this statement) Essay Example
8Psychological Pain Management
Psychological Pain Management
This paper is a comparison of facts in support of the role of psychological pain management as an important approach towards assistance of victims of chronic pain and facts against the approach. The importance of medical intervention in form of tests and treatments has been discussed and the importance of this approach in terms of the response time and the fact that the medications administered are supported by biological evidence. The essence of psychological pain management approach in addressing the non diagnosable causes of chronic pain and the fact that some cases of chronic pain persist even after the treatment of the medical conditions that were the cause of the pain, have been discussed. Also pointed out is the role of psychological pain management in re-establishment of comfortable operation of daily activities that had been interrupted by the persistent chronic pain.
Most people will experience pain in their lifetime. Those who are unfortunate enough to be insensitive to pain live complicated lives and will not usually live long (The British Psychological Society, 2011). Pain refers to a distasteful sensory and emotional experience which is closely linked with the damage of tissue or possible tissue damage. The definition directly points outs that pain is an emotional event. Pain is usually a result of tissue damage but not ordinarily. This can be confirmed by reports of extreme pain but with little observable damage to the tissues, and in other cases, extensive damage but with little pain. The reasons for this observation may be biological or psychological but of great importance is the understanding that people will have different pain behaviours and that the physical signs are not sufficient indicators of the level of pain (The British Psychological Society, 2011). Patients with chronic pain must be emotionally resilient since the condition considerably depletes the emotional reserves. The continuous quest for relief is always elusive resulting to feelings of helplessness and hopelessness, demoralization, and depression. Different approaches employed in the effort to assist chronic pain victims in their quest for relief. The role of psychological pain management in assisting such patients has however been a subject of discussion. This paper therefore investigates the role of this approach and finds the reasons why it may or may not be a useful approach in the treatment of victims of chronic pain.
Psychological Pain Management
The biomedical approach to treatment of pain associates pain with a specific disease condition that is a result of disordered biology. The diagnosis stage therefore involves investigation of physical damage and impairments so that the medical treatment is directed towards correction of the organ dysfunction or the source of pathology. There is evidence, however, that the presence of physical pathology do not sufficiently account for all the reported physical symptoms. Although there are records of responses to similar physical perturbations with identical treatments, the associations between physical impairments and pain reports and disability are modest at best. The biomedical approach does not consider most feature of chronic pain, like depression, sleep disturbance, psychological disability and pain, as pathognomonic for a specific disease, but the model views them as reactions of the conditions and thus treated as of secondary importance. It is assumed therefore that once the causing disease is cured, these secondary results will automatically evaporate failure to which they may be considered to have resulted from psychological causation. The model has thus received criticism emerging from its failure to address the psychosocial and psychological variables, particularly the dynamic interactions of the variables with the pathophysiological factors. Notably has been the case when symptoms are not commensurate with the intensity of observable pathology (Turk & Gatchel, 2002).
The gate control theory of pain approaches and the neuromatrix theory made tremendous efforts towards addressing the wide needs of chronic pain by their attempt to amalgate physiological factors and psychological factors and come up with a model that addresses the shortcomings of unidimensional models (Turk & Gatchel, 2002). It is evident that the treatment of these patients should integrate a psychological approach aimed at assisting the patients deal with the pain and be able to go on with their daily activities.
It has been found that addressing catastrophising and promotion of self-efficacy using cognitive behavioural techniques can greatly contribute to improved pain management (The British Pain Society 2010). Pain has increasingly been recognized as a complex perceptual experience that is influenced by several psychological factors. These factors include emotions, sociocultural background, the environmental context, the meaning if the pain to the person, as well as attitudes, expectations and beliefs and biological factors. Persistent pain will usually influence all the aspects of a person’s functioning: interpersonal, physical, emotional and avocational. Successful treatment for such chronic pain patients will not only require attention to the organic basis of the symptom but also those factors that modulate nociception and those that moderate the experience of pain and the related disability (Turk & Okifuji 2002).
A biopsychological approach views chronic pain as an illness and not a disease. The condition is therefore viewed as subjective experience so that treatment efforts are aimed at management, as opposed to cure of the chronic pain. There are numerous benefits of using psychological treatments in a multidisciplinary approach to chronic pain management. These include increased management of the pain by the patient, reduced pain related disability, improved pain coping resources and reduced emotional distress. These benefits are achieved through efforts that are focused on self-regulatory, cognitive and behavioural techniques. In this way, patients are made to feel in command of the pain control and are enabled to live normal life despite the persistent pain. The patients also become active participants in the management of their condition and become equipped with skills that they can live with throughout their lives (Roditi & Robinson, 2011).
The physical changes in the patient’s joints, nerves or muscles generate nociceptive input to the brain. The interpretation of these inputs will determine and identify the type of pain perceived by the patient, whether sharp, or burning, or punishing. The meaning attributed to the pain and the influences on subsequent behaviours will be influenced by the beliefs developed over the person’s lifetime. Depending on these beliefs and appraisal process, the individual may decide to ignore the pain and go on with his / her previous activity or the individual may stop work and assume the sick role (Turk & Okifuji 2002). The psychological assistance to the individual will therefore help him manage his perception of the pain and control its intensity rather than letting the individual be a slave of pain. This will however mean that pain will not just be considered as a consequence or byproduct of some other condition or injury, but the treatment will need to focus on the pain as an independent disease (Azar, 2011).
While psychological pain management approaches show great responses and improved pain management, the process has been found to take a long time for substantive outcomes to be noticed. The approach focuses on emotional and behavioural changes that will not obviously come within a few days. It involves several sessions with the psychologist and practice that may take months. During this time the patient is made to change his perception of pain and to modify his beliefs towards perception and response to pain. The long time taken to effectively accomplish the pain management is a great disadvantage to the patient who may be in need of fast relief. Yet again, the patient may be in so much pain that it might be useless for him to involve in psychological pain management productively. In this case medical interventions might be the only way to assist the patients. The other major advantage of medical interventions is that the treatment is based upon medical findings evidenced by the various medical tests. Common tests like magnetic resonance imaging, electromyography, X-rays and nerve conduction studies are great indicators of the forms and extents of such pains and may be used to determine the correct medication for reduction of the degree of pain (Cleveland clinic, 2013). This is particularly important since some causes of chronic pain are a result of previous injury or tissue damage. Performance of medical tests may therefore be the best way to intervene.
Going by the discussion above the role of psychological pain management in assisting chronic pain patients cannot be underestimated. The persistence of this condition and the fact that it influences the victims’ way of life is the major reason for the need of an effective program to manage the extents in its influence. There are several approaches to minimize the adverse effects of chronic pain with medical tests and treatment giving satisfactory results in faster realization of relief. While this has worked for some patients, others have shown conditions that cannot be diagnosed and haven’t been able to get relief from any approaches other than psychological experts. With the help of these experts, patients have been taken through sessions which equipped them with emotional and behavioural adjustments that have greatly helped them in the management of their conditions had that initially imprisoned them in pain and suffering. Psychological pain management therefore remains to be a concrete part of the efforts to assist victims of chronic pain.
The British Pain Society (2010). Cancer Pain Management. A perspective from the British Pain Society, supported by the Association for Palliative Medicine and the Royal College of General Practitioners. London: the British Pain Society.
Turk D. C. & Okifuji A. (2002). Psychological Factors in Chronic Pain: Evolution and Revolution. Journal of Consulting and Clinical Psychology, Vol 70, No. 3, 678-690.
Azar B. (2011). Psychology is key to pain management. American psychology association, Vol 42, No. 10, p 24.
The British Psychological Society (2011). A normal psychology of chronic pain. The psychologist. Volume 24-part 6 – 422-425.
Roditi D. & Robinson M. E. (2011). The role of psychological interventions in the management of patients with chronic pain. Psychol Res Behav Manag.; 4: 41–49.
Turk D. C. & Gatchel R. J. (2002). Psychological Approaches to Pain Management: A Practitioner’s Handbook. New York:Guilford Press.
Cleveland clinic (2013). Importance of Diagnosing and Evaluating Chronic Pain. Retrieved on 30th August 2013 from <http://my.clevelandclinic.org/disorders/chronic_pain/hic_importance_of_diagnosing_an d_evaluating_chronic_pain.aspx>
More Important Things