Pain Management Research Institute, Faculty of Medicine & Health, University of Sydney, NSW, 2028, Australia.
Pain Management Research Centre, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
Pain Manag. 2020 Nov;10(6):421-436. doi: 10.2217/pmt-2019-0039. Epub 2020 Oct 28.
Current treatments for chronic pain are often ineffective. At the same as searching for novel therapeutics, there is growing interest in preventing acute pain becoming chronic. While the field is still in its infancy, its knowledge base is increasingly expanding. Certainly, biomedical factors, for example, the type of tissue damage, are important but they are often not modifiable. Psychosocial risk factors (e.g., thoughts and beliefs about pain, mood, social support, workplace problems) are modifiable. There is an increasing body of research that cognitive behavioral therapy can prevent transition. Internet-based delivery of cognitive behavioral therapy improves access. Clinicians need to be aware that they may inadvertently promote pain chronification in their patients by what they say and do.
目前治疗慢性疼痛的方法往往效果不佳。在寻找新疗法的同时,人们越来越关注预防急性疼痛转为慢性疼痛。虽然该领域仍处于起步阶段,但它的知识库正在不断扩大。当然,生物医学因素(例如,组织损伤的类型)很重要,但往往不可改变。心理社会风险因素(例如,对疼痛、情绪、社会支持、工作场所问题的想法和信念)是可以改变的。越来越多的研究表明,认知行为疗法可以预防转变。基于互联网的认知行为疗法可以提高可及性。临床医生需要意识到,他们的言行可能会无意中促使患者的疼痛持续存在。