Psychological Theories of Pain

Abstract

While pain has traditionally been understood within a medical model that equates pain to tissue damage or disease, this understanding is not consistent with everyday observations of pain or with clinical examples of persistent pain where there is often very little correlation between pain experienced and physical findings.<br/> This article considers psychological and multidimensional theories of pain, which are described within the historical context within which they were developed, including behavioural, cognitive, contextual and functional theories.<br/> Research into the multifactorial nature of persistent pain has tended to focus on mechanisms of pain development and maintenance or on the function of pain. psychological approaches, which have focused on mechanism traditionally use disability, mood and quality of life measures to assess outcome, claiming little or no impact on pain intensity itself. By contrast, functional approaches include an explicit goal of reducing pain intensity, which is therefore measured as a key treatment outcome.<br/> Strong evidence exists from a range of sources of the important contribution of psychological and social factors to the experience of pain. However, evidence is still lacking about the specific mechanisms of change that are targeted by biopsychosocial interventions and about what treatment approach is likely to work best for whom.