Department of Physical Medicine & Rehabilitation, University of Michigan Health System, 325 E. Eisenhower Pkwy, Ann Arbor, MI 48108 USA ; Department of Physical Medicine & Rehabilitation, Ann Arbor Veterans Health Care System, Ann Arbor, MI 48105 USA.
Transl Behav Med. 2012 Mar;2(1):106-16. doi: 10.1007/s13142-011-0090-7.
The field of pain medicine has shifted from multidisciplinary rehabilitation to procedure-focused interventional pain medicine (IPM). Considerable controversy exists regarding the efficacy of IPM and its more narrow focus on nociception as an exclusive target of pain treatment. This topical review aims to examine pain research and treatment outcome studies that support a biopsychosocial model of pain, and to critique the clinical practice of IPM given its departure from the premises of a biopsychosocial model. A modern definition of pain and findings from clinical and basic science studies indicate that pain-related psychological factors are integral to pain perception. The clinical viability of IPM is challenged based upon its biomedical view of peripheral nociception as a primary source of pain and the potential of this viewpoint to foster maladaptive pain attributions and discourage the use of pain coping strategies among chronic pain patients. IPM should adopt a biopsychosocial perspective on pain and operate within a framework of multidisciplinary pain rehabilitation to improve its effectiveness.
疼痛医学领域已经从多学科康复转向以程序为中心的介入性疼痛医学（IPM）。关于 IPM 的疗效及其将伤害感受作为疼痛治疗的唯一靶点的更狭隘的关注存在相当大的争议。本专题综述旨在检查支持疼痛的生物心理社会模型的疼痛研究和治疗结果研究，并批评 IPM 的临床实践，因为它偏离了生物心理社会模型的前提。疼痛的现代定义以及临床和基础科学研究的结果表明，与疼痛相关的心理因素是疼痛感知的重要组成部分。基于其将外周伤害感受视为疼痛的主要来源的生物医学观点以及这种观点可能助长适应性疼痛归因和阻止慢性疼痛患者使用疼痛应对策略的观点，IPM 的临床可行性受到挑战。IPM 应该对疼痛采取生物心理社会的观点，并在多学科疼痛康复框架内运作，以提高其效果。
