lundi 20 juin 2011

A Biopsychosocial Approach to Chronic Pain: Epidemiology, Assessment & Treatment.

Pain is certainly one of the most common reasons for which patients seek medical treatment. The relief of pain is one of the physicians primary tasks, and the expectation of this relief often leads to the patient's idealization of the physician. While current understanding of the scientific basis of acute pain is minimal, that of chronic pain is even less. Chronic pain appears to serve no biological function, yet it remains resistant to treatment. Moreover, this condition seems to inhibit the patient's capacity to function and to enjoy life instead of serving the patient in some protective function. The patient gradually gives in to changes in behavior and affect, which in themselves are undesirable and maladaptive and, in turn, require treatment. Finally, besides the physical and emotional turmoil, chronic pain adds significant economic as well as social stress to the patient, family and society (Kouyanou, Pither, Rabe-Hesketh, & Wessely, 1998).

The present paper will present an overview of the latest advances in the literature related to non-pathological or benign-chronic pain. In other words, for purposes of this paper, chronic pain will refer to pain of a chronic nature for which no organic or tissu pathology is presently identified, eventhough the origins of that pain might have been of organic nature. The first section will present a biopsychosocial definition of chronic pain and will contrast chronic with acute pain. The second section will discuss the different methods that serve the assessment process of chronic pain. The third section will review the latest epidemiological data of chronic pain and will emphasize preventive care methods (primary, secondary and tertiary). The fourth section will present the role of treatment (biopsychosocial approaches) in dealing with chronic pain patients on an individual as well as on a community basis. Finally, the last section will outline some concluding remarks as well as future directions related to chronic pain research.