J Clin Outcomes Manage
Application of psychological strategies for pain management in primary care
Sanders KA, Donahue RG, Kerns RD
Abstract Objective: To review behavioral and cognitive behavioral strategies for pain management and describe their application in the primary care setting. Methods: The biomedical model, gate-control/neuromatrix theories, and biopsychosocial model for understanding chronic pain are discussed followed by a review of behavioral, self-regulatory, and cognitive behavioral treatments and research supporting their use. Results: Operant learning strategies, cognitive behavioral therapy, hypnosis, and biofeedback have been shown to improve patients' pain experience; however, many patients are not engaged in these treatments. Primary care providers may help prevent a cycle of pain and disability from occurring by organizing their treatment approach around the idea of pain management, not pain amelioration. They may help to promote patient motivation to engage in pain management therapies through the use of motivational interviewing strategies. Additionally, patient-centered education and counseling in primary care may facilitate the management of chronic pain. Conclusion: Primary care providers can help patients to manage their pain without an overreliance on medications or medical procedures. They can help dispel common misconceptions of psychological approaches, help patients set realistic goals for pain management, provide referrals for more comprehensive pain management treatment, and collaborate with other providers managing their patientsí pain.
Clinical Review Article
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