New Study Assesses Benefits of Cognitive Pain Relief Methods
Those who accept their pain condition are best able to tolerate pain, while distraction can be the way to lower pain intensity, according to research reported in The Journal of Pain, the peer review publication of the American Pain Society (http://www.americanpainsociety.org).
A team of German researchers evaluated the most common short-term cognitive pain management techniques for acute pain - acceptance, distraction and cognitive restructuring. They noted that little is known about the relative efficacy of acceptance strategies compared to other cognitive approaches, such as distraction and cognitive restructuring. The objective was to explore the differential short-term effects of these methods in a sample of 109 female students exposed to thermal mode experimental pain stimuli.
As an adjunctive pain treatment, acceptance is intended to disrupt the link between thoughts and behaviors so patients are willing to tolerate pain. The majority of experimental studies have shown that acceptance strategies are more effective at increasing pain tolerance than other pain regulation strategies.
In the study sample, distraction was used to shift attention away from pain stimulation to lessen pain intensity. With cognitive behavioral structuring, patients are trained to alter their appraisals of pain dysfunction in order to improve their ability to cope with pain. Proponents believe that restructuring pain-related thoughts may affect disability-related behavior, such as avoiding work or recreational activities in fear of pain.
Results of the study showed that acceptance led to increased pain tolerance relative to cognitive restructuring and distraction lowered pain intensity compared to acceptance. No significant differences were detected between distraction and acceptance with regard to pain tolerance. The authors concluded that cognitive restructuring was no different from distraction for increasing pain tolerance. They noted that from a clinical perspective knowledge about cognitive pain management strategies can be useful in gauging treatment outcomes and for refining the treatment of chronic pain.
Pain may be defined as an unpleasant sensory or emotional experience associated with actual or potential tissue damage. Chronic pain is defined as pain still present after three months despite appropriate treatment. Breakthrough pain is defined as pain of moderate or severe intensity occurring against a background of controlled chronic pain.
Controlling pain, whether acute or chronic, is a common task for every doctor. A survey of 975 people in the UK reported that 21% experienced pain every day or on most days. 67% had visited their GP or a walk-in centre, requesting advice about pain relief.
The simplistic view of the pain-producing system (‘hard-wiring’) in which pain sensations are conducted via the nerves to the spinal cord fails to explain such phenomena as phantom limb pain and pain experienced after cordotomy. Pain specialists now talk about plasticity, in which the central nervous system (CNS) adapts to new situations and ‘rewires’ itself.
Emotional, environmental and social factors are becoming increasingly recognised as issues which need to be addressed in the management of chronic pain.
Treat underlying causes wherever possible.
Take an adequate history
Pain is often mistreated or undertreated and can lead to depression, insomnia, lethargy and reduced physical and mental functioning. Successful control is more likely to be achieved if a proper assessment is made, which should include:
The site of the pain.
The duration, speed of onset and whether the pain is intermittent or constant.
The character of the pain - this will indicate whether it is neuropathic or nociceptive, somatic or visceral.
Aggravating and relieving factors.
Impact on daily living.
Social, emotional and psychological aspects.
Severity - use of pain scales can make this more objective.
About the American Pain Society
Based in Glenview, Ill., the American Pain Society (APS) is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering. APS was founded in 1978 with 510 charter members. From the outset, the group was conceived as a multidisciplinary organization. The Board of Directors includes physicians, nurses, psychologists, basic scientists, pharmacists, policy analysts and others.
Pain Relief Options
Labour pain is different for every woman. Many women cope with pain with the help of:
a supportive person
breathing techniques
relaxation
warm baths
showers
changing positions
massage and/or visualization
ice packs
acupuncture and/or acupressure
hypnosis
Sometimes women in labour need additional pain relief. This table outlines some options for pain relief medications during labour and birth.
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Source Newsroom: American Pain Society