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The alternative to medicine or combined approaches to pain management are broad and each of which can be based upon different paradigms of understanding pain. The different approaches come from the wide range of healthcare professionals unique treatments towards pain management, not only limited to Mental-Health or Psychiatrists but can include Physiotherapists, Occupational Therapists, Nurse Practitioners, Medics, Nuse Specialists and Massage Therapists.
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The alternative to medicine or combined approaches to pain management are broad and each of which can be based upon different paradigms of understanding pain. The different approaches come from the wide range of healthcare professionals unique treatments towards pain management, not only limited to Mental-Health or Psychiatrists but can include Physiotherapists, Occupational Therapists, Nurse Practitioners, Medics, Nuse Specialists and Massage Therapists.<br>
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=== Different Types of Management/Treatment ===
=== Different Types of Management/Treatment ===
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*Acceptance and Commitment Therapy
*Acceptance and Commitment Therapy
*Hypnosis
*Hypnosis
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*Biofeedback
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*Biofeedback<br>
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== What is the Psychological Approach to Pain Management ==
== What is the Psychological Approach to Pain Management ==
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As well as the neural interactions and links the brain goes through when a person is in pain, there are multiple layers of complex abstract thoughts and feelings a person goes through which culminates how much pain a person feels and how they deal with pain. Their cognitive constructs, behavioural constructs and environmental influences are all intertwined in a complex web of individuality which need to be considered and incorporated into any treatments for them to be effective and are found out during an initial assessment<ref name="asm">Asmundson,G. Gomez-Perez,L. Richter, A. Carleton, RN. The psychology of pain: models and targetsfckLRfor comprehensive assessment. Chapter 4 in Hubert van Griensven’s Pain: A text book for health care professionals. Elsevier, 2014.</ref>. It is these personal, individual and holistic areas which make it a pscyhological approach sitting within the biopsychosocial model of patient treatment.
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As well as the neural interactions and links the brain goes through when a person is in pain, there are multiple layers of complex abstract thoughts and feelings a person goes through which culminates how much pain a person feels and how they deal with pain. Their cognitive constructs, behavioural constructs and environmental influences are all intertwined in a complex web of individuality which need to be considered and incorporated into any treatments for them to be effective and are found out during an initial assessment<ref name="asm">Asmundson,G. Gomez-Perez,L. Richter, A. Carleton, RN. The psychology of pain: models and targetsfckLRfor comprehensive assessment. Chapter 4 in Hubert van Griensven’s Pain: A text book for health care professionals. Elsevier, 2014.</ref>. It is these personal, individual and holistic areas which make it a pscyhological approach sitting within the biopsychosocial model of patient treatment.<br>
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= The Difference Between Acute and Chronic Pain =
= The Difference Between Acute and Chronic Pain =
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Previously pain used to fit into the biomedical model with a reductionist view (i.e Pain was derived from a specific physical pathology) and catagorically dismissed social, psychological and behavioural mechanisms as irrelevent and of no importance to understanding pain<ref name="asm" />. This is grossly oversimplified and now we understand that pain is more than a simple response to a physical stimulus and in recent years several models of pain models have been created to explain and develop our understanding of pain.
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Previously pain used to fit into the biomedical model with a reductionist view (i.e Pain was derived from a specific physical pathology) and catagorically dismissed social, psychological and behavioural mechanisms as irrelevent and of no importance to understanding pain<ref name="asm" />. This is grossly oversimplified and now we understand that pain is more than a simple response to a physical stimulus and in recent years several models of pain models have been created to explain and develop our understanding of pain. <br>
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Acute pain can be defined as:
Acute pain can be defined as:
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As the definition states, acute pain is a '''predicted''' response to a stimulus. If you have had surgery to repair and fractured hip, there will be a usual pattern of pain and rate of recovery based upon the patients demographics. However to take this definition further one could say that pain is:
As the definition states, acute pain is a '''predicted''' response to a stimulus. If you have had surgery to repair and fractured hip, there will be a usual pattern of pain and rate of recovery based upon the patients demographics. However to take this definition further one could say that pain is:
<blockquote>a complex perceptual phenomenon that involves a number of dimensions, including, but not limiting to, intensity, quality, time course and personal meaning<ref name="Mer">Merskey, H., Bogduk, N., 1994.fckLRClassification of chronic pain:fckLRdescriptions of chronic painfckLRsyndromes and definitions of painfckLRterms, second ed. IASP Press, Seattle</ref>. </blockquote>
<blockquote>a complex perceptual phenomenon that involves a number of dimensions, including, but not limiting to, intensity, quality, time course and personal meaning<ref name="Mer">Merskey, H., Bogduk, N., 1994.fckLRClassification of chronic pain:fckLRdescriptions of chronic painfckLRsyndromes and definitions of painfckLRterms, second ed. IASP Press, Seattle</ref>. </blockquote>
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This definition incorporates the modern thinking of pain, not just acute pain but pain as a whole. The first definition is still true in the fact that acute pain is predictable and does follow a pattern but the second quote reflects the more complex nature of pain and is a reminder that pain should not be thought of as the same for all patients. It becomes even more complex when pain changes from the predictable pattern of duration and nature to an unpredictable and unexplained phenomenon that exceeds the usual duration of healing and becomes chronic.
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This definition incorporates the modern thinking of pain, not just acute pain but pain as a whole. The first definition is still true in the fact that acute pain is predictable and does follow a pattern but the second quote reflects the more complex nature of pain and is a reminder that pain should not be thought of as the same for all patients. It becomes even more complex when pain changes from the predictable pattern of duration and nature to an unpredictable and unexplained phenomenon that exceeds the usual duration of healing and becomes chronic.<br>
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Chronic pain can be defined as when:
Chronic pain can be defined as when:
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As with all models there is some difference on opinion with certain respects, such as which aspect has the greatest influence on pain perception, however biopsychosocial models all agree on the central focus; the focus is not on a disease but on the behaviour around the disease, feeding and fueling beliefs and attitude which perpetuates a problem. The central argument, as stated, is illness behaviour which implies that individuals may differ in perception of an response to bodily sensations and changes (e.g. pain, nausea, heart palpitations), and that these differences can be understood in the context of psychological and social processes<ref name="asm" />. <br>
As with all models there is some difference on opinion with certain respects, such as which aspect has the greatest influence on pain perception, however biopsychosocial models all agree on the central focus; the focus is not on a disease but on the behaviour around the disease, feeding and fueling beliefs and attitude which perpetuates a problem. The central argument, as stated, is illness behaviour which implies that individuals may differ in perception of an response to bodily sensations and changes (e.g. pain, nausea, heart palpitations), and that these differences can be understood in the context of psychological and social processes<ref name="asm" />. <br>
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= Treatments - Psychological Approach =
= Treatments - Psychological Approach =
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[http://www.ncbi.nlm.nih.gov/pubmed/2961080 A New Clinical Model for the Treatment of Low Back Pain.] by Waddell<ref name="Waddell">Waddell G. 1987 Volvo award in clinical sciences. A new clinical model for the treatment of low-back pain. Spine. 1987 12;7:632-44</ref>.
[http://www.ncbi.nlm.nih.gov/pubmed/2961080 A New Clinical Model for the Treatment of Low Back Pain.] by Waddell<ref name="Waddell">Waddell G. 1987 Volvo award in clinical sciences. A new clinical model for the treatment of low-back pain. Spine. 1987 12;7:632-44</ref>.
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[http://books.google.co.uk/books?hl=en&lr=&id=LmgEkK0OvEwC&oi=fnd&pg=PA1&dq=Turk,+D.C.,+Meichenbaum,+D.,++Genest,+M.,+1983.+Pain+and+behavioral++medicine:+A+cognitive-behavioral++perspective.&ots=xPmnVvMXKh&sig=kpGmuQWKlPXmrdbT67hFjwcaA7k#v=onepage&q&f=false Pain and Behavioural Medicine: A Cognitive-Behavioural Perspective.] By Turk
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[http://books.google.co.uk/books?hl=en&lr=&id=LmgEkK0OvEwC&oi=fnd&pg=PA1&dq=Turk,+D.C.,+Meichenbaum,+D.,++Genest,+M.,+1983.+Pain+and+behavioral++medicine:+A+cognitive-behavioral++perspective.&ots=xPmnVvMXKh&sig=kpGmuQWKlPXmrdbT67hFjwcaA7k#v=onepage&q&f=false Pain and Behavioural Medicine: A Cognitive-Behavioural Perspective.] By Turk<br>
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=== Other [http://www.physio-pedia.com/Main_Page Physio-Pedia] Pages ===
=== Other [http://www.physio-pedia.com/Main_Page Physio-Pedia] Pages ===
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[http://www.physio-pedia.com/Pain_Course Pain Course] [http://www.physio-pedia.com/Pain_Assessment Pain Assessment] [http://www.physio-pedia.com/Cognitive_Behavioural_Therapy Cognitive Behavioural Therapy] [http://www.physio-pedia.com/Category:Pain All Physio-Pedia pages with PAIN as their category.]
[http://www.physio-pedia.com/Pain_Course Pain Course] [http://www.physio-pedia.com/Pain_Assessment Pain Assessment] [http://www.physio-pedia.com/Cognitive_Behavioural_Therapy Cognitive Behavioural Therapy] [http://www.physio-pedia.com/Category:Pain All Physio-Pedia pages with PAIN as their category.]
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= References =
= References =