Evidence-based approach for Chronic Pain



Assessment

Psychological assessment for chronic pain focuses not only on pain, but also on the patient’s beliefs about pain, pain fearfulness, self-efficacy, pattern of activity, usual coping strategies, and co-morbid conditions.

It is important for patients to be examined by their medical practitioners to ensure there is no malignant disease underlying the pain they experience or that they are suitable for surgery.

Treatment

Cognitive behaviour therapy (CBT) is the gold standard approach in the management of chronic pain and has the strongest evidence base. This approach includes a combination of:

  • Psycho-education of chronic pain
  • Graded goal setting (ie. pacing and exercises)
  • Relaxation techniques
  • Attentional strategies
  • Cognitive restructuring
  • Problem solving
  • Assertiveness
  • Communication
There is research conducted on acceptance and commitment therapy (n=3), and mindfulness-based therapy (n=7), but they have methodological issues, and they have not been found to be superior to CBT.

Thus, CBT should be the first line of treatment for the management of chronic pain.

Evidence-Based Self-Help Books



References

Evidence-Based Treatment Manuals