Book Chronic Pain: An Integrated Biobehavioral Approach

[Diane]

Here is an interview with the two authors, Herta Flor and Dennis Turk, both well known in pain science circles.

Excerpt:

Health care providers as well as patients tend to believe in what we call an acute illness model, in which the presence of symptoms is an indication of underlying physical pathology. The assumption is that once the cause of the symptoms is identified, it should be removed, or if that is not possible, then treatments should be provided—whether pharmacological or surgical—that cut or block the “pain signals.” If pain persists, then a quest begins to find THE treatment that will resolve the problem. Unfortunately, there may not be any treatment that can eliminate all of the pain, yet the futile search drags on and may contribute to even greater disability.

Oh yeah. For sure.

We strongly advocate customizing treatments to individual patient needs and characteristics. Having said that, we are only just beginning to learn about how to match treatments to individual patients.

Recent treatment methods that focus on the reversal of brain changes related to chronic pain attempt to eliminate pain memory traces from the brain. This can be accomplished by a number of methods, including pain extinction training, which focuses on reducing pain-related behaviors and increasing positive pain-incompatible behaviors. Other promising methods include cognitive interventions that divert attention from the pain and treatments such as mirror therapy or virtual reality training that provide feedback of an intact body to the brain. Various types of biofeedback may achieve similar results. They all have the goal of altering maladaptive brain changes by providing “normal feedback” to the brain, which helps to target maladaptive changes and replace them with non-pain-related positive associations.

I should think that ideomotion and (intelligent!) manual therapy could do that too. Through somatosensory channels. Provide novel fuel to cognitive (descendingly modulatory) pathways.

psychological methods may be the best alternatives for use when sophisticated and expensive interventions are not available.

[zimney3pt]

Looks like might be a good read when it is released in Sept.

[eburkedpt]

Can someone give an example of pain extinction training?

Evan