The psychology of pain and its management

Pain is among the most common somatic complaints. Fortunately, in only a minority of people is pain long lasting and severe, such that it interferes with daily life activities. Those with chronic, disabling pain present to healthcare providers repeatedly. Often they experience anxiety and depression, irritation, frustration and helplessness, and they suffer from insomnia and excessive medication use. It is well known that this group of chronic sufferers is difficult to treat: there is no immediate and definitive solution available for their pain problem. Therefore, treatment objectives consist of learning to control the somatic complaints and to improve the quality of life. In this paper, the importance of cognitive and behavioural processes in the experience of chronic pain and in pain-associated disability are discussed. First, pain is viewed from a traditional perspective that assumes a direct and immediate relationship between tissue damage, pain experience and disability. Next, pain is considered within a biopsychosocial perspective. Implications for the treatment of patients with chronic pain problems are outlined. We summarise theoretically grounded and effective treatment strategies in patients with pain, and conclude with emergent themes for future research and the improvement of clinical practice.