Managing Pain

Abstract:

The prevalence and cost of chronic pain is a major mental and physical health care problem in the United States. As a result, this has fueled a great deal of clinical research on the assessment and treatment of chronic pain. Such clinical research has led to the development of the biopsychosocial model of chronic pain, which has been shown to be the most widely accepted and most heuristic perspective in the assessment and treatment of chronic pain. This model uses physiologic, biologic, cognitive, emotional, behavioral and social factors (as well as their interplay) when explaining a patient’s report of pain. In fact, in order to comprehensively assess chronic pain, one must be certain to account for such potential interactions before prescribing the best treatment regimen, which must also be individually tailored for a particular patient. The present chapter will review this biopsychosocial model, and also discuss how the model has led to the development of comprehensive interdisciplinary pain-management programs. These interdisciplinary programs have been demonstrated to be more treatment- and cost-effective than traditional medical programs that focus only presumed pathophysiology. A review of the core ingredients of these pain-management programs will be provided, as well as the basic mechanisms of change underlying such intervention and the basic competencies of health care providers involved in such interdisciplinary pain management.

This research is supported in parts by grants 5R01 MH46452 and 1K05 MH71892 from the National Institutes of Health and grant No. DAMD17-03-1-0055 from the Department of Defense.