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To control or not? A motivational perspective on coping with pain

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Abstract

Pain relief is often the primordial treatment objective in pain patients. However, an exclusive focus upon pain relief may have costs. Evidence is accumulating that persistent attempts to gain control over pain may, paradoxically, hinder successful adaptation to pain and increase frustration and limitations due to pain. To better understand these apparently paradoxical findings, we propose to adopt a motivational perspective on coping with pain. Within this perspective, pain control is recast as an attempt to protect and restore valued life goals threatened by pain. This framework explains why some patients engage excessively in pain control strategies despite the costs associated with this, such as overuse of medication. A clinical implication is that cautiousness is warranted in promoting strategies exclusively aimed at pain relief. Beyond standard medical care, interventions should also be aimed at the improvement of functioning despite pain. Certainly those patients for whom there is no definite or sound cure to pain and who increasingly experience emotional and physical problems due to pain might benefit from paramedical help by psychologists and/or physiotherapists.

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References

  1. Jensen MP, Karoly P (1991) Control beliefs, coping efforts, and adjustment to chronic pain. J Consult Clin Psychol 59:431–438

    Article  PubMed  CAS  Google Scholar 

  2. Buckelew SP, Parker JC, Keefe FJ, Deuser WE, Crews TM et al (1994) Self-efficacy and pain behavior among subjects with fibromyalgia. Pain 59:377–384

    Article  PubMed  CAS  Google Scholar 

  3. Overmier JB, Seligman MEP (1967) Effects of inescapable shock upon subsequent escape and avoidance learning. J Comp Physiol Psychol 63:23–33

    Article  Google Scholar 

  4. Nicassio PM, Schuman C, Radojevic V, Weisman MH (1999) Helplessness as a mediator of health status in fibromyalgia. Cognit Ther Res 23:181–196

    Article  Google Scholar 

  5. Koleck M, Mazaux JM, Rascle N, Bruchon-Schweitzer M (2006) Psycho-social factors and coping strategies as predictors of chronic evolution and quality of life in patients with low back pain: a prospective study. Eur J Pain 10:1–11

    Article  PubMed  Google Scholar 

  6. Crombez G, Eccleston C, De Vlieger P, Van Damme S, De Clercq A (2008) Is it better to have controlled and lost than never to have controlled at all? An experimental investigation of control over pain. Pain 2008(137):631–639

    Article  Google Scholar 

  7. Crombez G, Eccleston C, Van Hamme G, De Vlieger P (2008) Attempting to solve the problem of pain: a questionnaire study in acute and chronic pain patients. Pain 137:556–563

    Article  PubMed  Google Scholar 

  8. Eccleston C, Crombez G (2007) Worry and chronic pain: a misdirected problem solving model. Pain 132:233–236

    Article  PubMed  Google Scholar 

  9. Van Damme S, Crombez G, Eccleston C (2008) Coping with pain: a motivational perspective. Pain 139:1–4

    Article  PubMed  Google Scholar 

  10. Lazarus RS, Folkman S (1984) Stress, appraisal and coping. Springer, New York

    Google Scholar 

  11. Skinner EA, Edge K, Altman J, Sherwood H (2003) Searching for the structure of coping: a review and critique of category systems for classifying ways of coping. Psychol Bull 129:269–316

    Article  Google Scholar 

  12. Eccleston C, Crombez G (1999) Pain demands attention: a cognitive–affective model of the interruptive function of pain. Psychol Bull 125:356–366

    Article  PubMed  CAS  Google Scholar 

  13. Karoly P, Ruehlman LS (2007) Psychosocial aspects of pain-related life task interference: an exploratory analysis in a general population sample. Pain Med 8:563–572

    Article  PubMed  Google Scholar 

  14. Brandtstädter J, Rothermund K (2002) The life-course dynamics of goal pursuit and goal adjustment: a two-process framework. Dev Rev 22:117–150

    Article  Google Scholar 

  15. Hasenbring MI, Verbunt JA (2010) Fear-avoidance and endurance-related responses to pain: new models of behavior and their consequences for clinical practice. Clin J Pain 26:747–753

    Article  PubMed  Google Scholar 

  16. Hasenbring M, Marienfield G, Kuhlendahl D, Soyka D (1994) Risk factors of chronicity in lumbar disc patients: a prospective investigation of biologic, psychologic, and social predictors of therapy outcome. Spine 19:2759–2765

    Article  PubMed  CAS  Google Scholar 

  17. Hasenbring MI, Plaas H, Fishbein B, Willburger R (2006) The relationship between activity and pain in patients 6 months after lumbar disc surgery: do pain-related coping modes act as moderator variables? Eur J Pain 10:701–709

    Article  PubMed  Google Scholar 

  18. Keefe FJ, Rumble ME, Scipio CD, Giordano LA, Perri LM (2004) Psychological aspects of persistent pain: current state of the science. J Pain 5:195–211

    Article  PubMed  Google Scholar 

  19. De Vlieger P, Van den Bussche E, Eccleston C, Crombez G (2006) Finding a solution to the problem of pain: conceptual formulation and the development of the pain solutions questionnaire (PaSol). Pain 123:285–293

    Article  PubMed  Google Scholar 

  20. Goubert L, Crombez G, De Bourdheaudhuij I (2004) Low back pain, disability and back pain myths in a community sample: prevalence and interrelationships. Eur J Pain 8:385–394

    Article  PubMed  Google Scholar 

  21. Coudeyre E, Rannou F, Tubach F, Baron G, Coriat F et al (2006) General practitioners’ fear-avoidance beliefs influence their management of patients with low back pain. Pain 124:330–337

    Article  PubMed  Google Scholar 

  22. Goubert L, Crombez G, Danneels L (2005) The reluctance to generalize corrective experiences in chronic low back pain patients: a questionnaire study of dysfunctional cognitions. Behav Res Ther 43:1055–1067

    Article  PubMed  Google Scholar 

  23. Vlaeyen JWS, Linton SJ (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85:317–332

    Article  PubMed  CAS  Google Scholar 

  24. Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma K et al (2007) The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. Behav Med 30:77–94

    Article  Google Scholar 

  25. Silberstein SD (2005) Clinical practice guidelines. Cephalalgia 25:765–766

    Article  PubMed  CAS  Google Scholar 

  26. Wiendels NJ, van Haestregt A, Neven AK, Spinhoven P, Zitman FG et al (2006) Chronic frequent headache in the general population: comorbidity and quality of life. Cephalalgia 26:1443–1450

    Article  PubMed  CAS  Google Scholar 

  27. Bigal ME, Lipton RB (2008) Excessive acute migraine medication use and migraine progression. Neurology 71:1821–1828

    Article  PubMed  CAS  Google Scholar 

  28. Lauwerier E, Paemeleire K, Van Damme S, Goubert L, Crombez G (2011) Medication use in patients with episodic migraine and medication-overuse headache: the role of problem-solving and attitudes about pain medication. Pain 152:1334–1339

    Article  PubMed  Google Scholar 

  29. McCracken LM, Vowles KE, Eccleston C (2004) Acceptance of chronic pain: component analysis and a revised assessment method. Pain 107:159–166

    Article  PubMed  Google Scholar 

  30. Viane I, Crombez G, Eccleston C, Poppe C, Devulder J et al (2003) Acceptance of pain is an independent predictor of mental well-being in patients with chronic pain: empirical evidence and reappraisal. Pain 106:65–72

    Article  PubMed  Google Scholar 

  31. McCracken LM, Eccleston C (2005) A prospective study of acceptance of pain and patient functioning with chronic pain. Pain 118:164–169

    Article  PubMed  Google Scholar 

  32. Morley S, Eccleston C, Williams A (1999) Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy for chronic pain in adults, excluding headache. Pain 80:1–13

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Emelien Lauwerier.

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Lauwerier, E., Van Damme, S., Goubert, L. et al. To control or not? A motivational perspective on coping with pain. Acta Neurol Belg 112, 3–7 (2012). https://doi.org/10.1007/s13760-012-0020-6

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  • DOI: https://doi.org/10.1007/s13760-012-0020-6

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