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Citation
Tags
HERO ID
7190033
Reference Type
Journal Article
Title
Theoretical Considerations for Chronic Pain Rehabilitation
Author(s)
Lotze, M; Moseley, GL; ,
Year
2015
Is Peer Reviewed?
1
Journal
Physical Therapy
ISSN:
0031-9023
Publisher
OXFORD UNIV PRESS INC
Location
CARY
Page Numbers
1316-1320
Language
English
PMID
25882484
DOI
10.2522/ptj.20140581
Web of Science Id
WOS:000360570600012
Abstract
Conventional rehabilitation of patients with chronic pain is often not successful and is frustrating for the treatment team. However, theoretical developments and substantial advances in our understanding of the neurological aspects of chronic pain are changing these experiences. Modern theoretical models of pain consider pain to be a perceptual inference that reflects a "best guess" that protective action is required. This article argues that keen observation and open and respectful clinician-patient and scientist-clinician relationships have been critical for the emergence of effective rehabilitation approaches and will be critical for further improvements. The role in modern pain rehabilitation of reconceptualizing the pain itself-by "Explaining Pain," careful and intentional observation of the person in pain, and the strategic and constant communication of safety-is emphasized. It also is suggested that better understanding of the neural mechanisms underpinning chronic pain has directly informed the development of new therapeutic approaches, which are being further refined and tested. Conventional pain treatment (where the clinician strives to find the pain-relieving medication or exercise) or pain management (where the clinician helps the patient to manage life despite unabating pain) is being replaced by pain rehabilitation, where a truly biopsychosocial approach allows clinicians to provide patients with the knowledge, understanding, and skills to reduce both their pain and disability. A brief overview is provided of the key aspects of modern pain rehabilitation and the considerations that should lead our interaction with patients with chronic pain.
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