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Book Details
Abstract
This title is directed primarily towards health care professionals outside of the United States. It deals specifically with the management of potentially chronic l pain, how to assess patients with pain, the factors involved in the development of chronic pain and the setting up and running of a pain management programme. The main focus is on musculoskeletal and fibromyalgic type pain. Cancer pain is not addressed. The authors address not only what is recommended in the management of pain but also whether and why it is done, thereby covering not only the content of interdisciplinary pain management but also the processes involved.
- Provides extensive background material and covers broad issues which other books lack
- Focuses on not only what is done with the management of pain but whether and why it is done
- Includes the nuts and bolts of setting up and running a pain management programme
- Addresses the application of pain management programmes in a wide range of fields
- Has a multidisciplinary approach and therefore appeals to a multidisciplinary market
- Two new co-authors: Kay Greasley and Bengt Sjolund.
- Major restructuring of chapters and rewriting of content with new authors for many of them.
- Greatly increased discussion of biopsychosocial management in individual clinical practice.
- Addresses the needs of the individual practitioners as well as those working in specialised pain management units.
- Includes more on primary care and secondary pain prevention.
- Expanded discussion of the clinical-occupational interfaces.
- Particular emphasis on the identification and targeting of modifiable risk factors for chronic pain and prolonged disability.
- The following topics stregthened throughout: communication, the nature of groups, medication and iatrogenics.
- Potential of an evidence-based biopsychosocial approach to pain management highlighted.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Pain Management: Practical Applications of the Biopsychosocial Perspective in Clinical and Occupational Settings | iii | ||
| Copyright Page | iv | ||
| Foreword | vii | ||
| Acknowledgements | viii | ||
| Foreword | ix | ||
| Preface | xi | ||
| Section One: Models and mechanisms | 1 | ||
| Chapter 1. Models of pain and disability | 3 | ||
| Introduction | 3 | ||
| Early theories of pain | 4 | ||
| The gate control theory | 9 | ||
| A modern understanding of pain mechanisms | 11 | ||
| Psychobiology | 12 | ||
| Pain perception | 16 | ||
| From pain mechanisms to models of illness | 18 | ||
| From theoretical models to clinical practice | 20 | ||
| Models of disability | 22 | ||
| Concluding reflections | 25 | ||
| References | 25 | ||
| Chapter 2. Psychological mechanisms | 29 | ||
| Lessons from the history of medicine | 29 | ||
| Historical foundations of the modern psychology of pain | 30 | ||
| Psychological influences on pain and incapacity: a clinical overview | 32 | ||
| Psychological impact of different types of pain | 33 | ||
| Pain and emotion | 33 | ||
| Cognitive influences on the experience of pain | 35 | ||
| Pain behaviour | 42 | ||
| Coping styles and strategies | 44 | ||
| Pain as a multidimensional bio-behavioural system | 48 | ||
| Targets for intervention and obstacles to recovery | 49 | ||
| Conclusion | 51 | ||
| References | 52 | ||
| Chapter 3. The psychological impact of pain and disability | 57 | ||
| Historical perspective | 57 | ||
| Chronic pain and psychopathology | 58 | ||
| To treat or not to treat? The nature of clinical decision making | 58 | ||
| Presenting psychological characteristics | 60 | ||
| Identification of psychiatric illness | 61 | ||
| Conclusion | 68 | ||
| References | 69 | ||
| Chapter 4. Cultural and social influences on pain and disability | 73 | ||
| Introduction | 73 | ||
| Cultural influences | 73 | ||
| The influence of demographic factors | 80 | ||
| Specific influences of the family context | 85 | ||
| Professional–patient communication | 87 | ||
| The special influence of compensation and litigation | 93 | ||
| Summary and conclusion | 93 | ||
| References | 94 | ||
| Chapter 5. Risk identification and screening | 97 | ||
| Introduction | 97 | ||
| Concepts of risk and risk identification | 98 | ||
| From public health strategies to management of pain in the individual | 99 | ||
| Nature of screening | 100 | ||
| General approaches to screening | 102 | ||
| Risk factors for the development of pain | 107 | ||
| Risk factors for the persistence of pain, pain-associated limitations and work compromise | 109 | ||
| Classification, clustering and screening | 111 | ||
| Screening and targeting | 118 | ||
| Conclusions re risk identification and screening | 121 | ||
| References | 123 | ||
| Section Two: Assessment | 133 | ||
| Chapter 6. Biomedical and pain assessment in secondary and tertiary-care settings | 135 | ||
| Introduction | 135 | ||
| Role of the physician | 136 | ||
| Pain evaluation | 138 | ||
| Physical examination | 139 | ||
| Appraisal and rationalisation of medication use | 140 | ||
| Communicating with the patient | 141 | ||
| Communicating with colleagues | 141 | ||
| References | 142 | ||
| Chapter 7. The assessment of pain and function | 145 | ||
| Introduction | 145 | ||
| The context of pain assessment | 146 | ||
| More general measurement considerations | 153 | ||
| Assessment of physical functioning | 154 | ||
| Measures of physical function and impairment | 156 | ||
| Measures of disability | 160 | ||
| Occupational outcome | 162 | ||
| Conclusion | 163 | ||
| References | 164 | ||
| Chapter 8. Psychological assessment | 169 | ||
| Introduction | 169 | ||
| General context | 169 | ||
| Methods of assessment | 170 | ||
| Determination of general suitability for pain management | 175 | ||
| General issues in the assessment of psychopathology | 176 | ||
| Mental health problems as psychological targets for intervention | 178 | ||
| Psychological risk factors for persisting pain and disability | 181 | ||
| Conclusions | 183 | ||
| References | 184 | ||
| Section Three: Psychosocial interventions | 195 | ||
| Chapter 9. The nature of psychosocial interventions | 197 | ||
| Introduction | 197 | ||
| The case for early intervention | 198 | ||
| The nature of interventions | 198 | ||
| Approaches to communication | 200 | ||
| The importance of reassurance | 201 | ||
| Dealing with distress | 202 | ||
| Psychosocial interventions and complementary and alternative medicine (CAM) | 202 | ||
| The cognitive–behavioural approach | 204 | ||
| Delivery of individualised psychosocial interventions in primary-care and community settings | 205 | ||
| Early pain management: the role of other health-care professionals? | 209 | ||
| The issue of competency in delivery of early intervention programmes: using physiotherapy as an example | 213 | ||
| Conclusions | 214 | ||
| References | 216 | ||
| Chapter 10. Intervention models and techniques | 219 | ||
| Introduction | 219 | ||
| Evolution of psychological approaches to the treatment of pain conditions | 219 | ||
| Specific intervention approaches for chronic pain and disability | 221 | ||
| Specific intervention techniques used in pain management | 224 | ||
| Conclusions | 236 | ||
| References | 236 | ||
| Section Four: Tertiary pain management programmes | 239 | ||
| Chapter 11. Tertiary pain management programmes | 241 | ||
| Part 1 Introduction | 241 | ||
| The origin and development of modern pain management | 242 | ||
| The cognitive–behavioural perspective | 242 | ||
| The challenge of interdisciplinary pain management | 242 | ||
| Major therapeutic objectives of PMPs | 245 | ||
| Minimising the psychological impact of chronic pain | 246 | ||
| Restoration of function including occupationally oriented rehabilitation | 248 | ||
| Conclusion | 249 | ||
| References | 249 | ||
| Part 2 Setting the scene: Introduction to the PMP | 253 | ||
| General aims | 254 | ||
| Programme structure | 254 | ||
| Preparation for the programme | 255 | ||
| The initial session(s) of the programme | 255 | ||
| Conclusion | 262 | ||
| References | 262 | ||
| Part 3 Medical component | 263 | ||
| Pain pathways | 263 | ||
| Diagnoses and investigations | 264 | ||
| Medicines: how to get the best out of them | 265 | ||
| The management of flare-ups | 271 | ||
| A patient's guide to how to survive the health-care system | 273 | ||
| Conclusion | 274 | ||
| References | 274 | ||
| Part 4 Physiotherapy component | 275 | ||
| Introduction | 275 | ||
| Techniques for increasing physical activity | 276 | ||
| The influence of psychological factors on performance | 278 | ||
| The establishment of appropriate goals | 278 | ||
| Approaches to reactivation: aerobic conditioning | 279 | ||
| Approaches to reactivation: stretching | 280 | ||
| Approaches to reactivation: strengthening and endurance exercises | 281 | ||
| Ergonomics, lifting and handling exercises | 283 | ||
| Practice and practical work | 284 | ||
| Conclusion | 284 | ||
| References | 286 | ||
| Part 5 Psychological component | 294 | ||
| Introduction | 294 | ||
| Enhancing overall participation in programme | 295 | ||
| Developing an understanding of the stress–pain interface | 296 | ||
| Training in stress reduction techniques | 297 | ||
| Common difficulties encountered in mastering relaxation skills | 299 | ||
| Cognitive restructuring and chronic pain | 300 | ||
| Changing behaviour using problem-solving techniques | 300 | ||
| Tackling interpersonal relationships | 301 | ||
| Sleep management | 302 | ||
| Working with partners (or significant others) | 302 | ||
| Conclusion | 303 | ||
| References | 304 | ||
| Part 6 The nature of therapeutic groups | 304 | ||
| Introduction | 304 | ||
| Advantages and disadvantages of groups | 305 | ||
| Preparing for group participation | 305 | ||
| Enhancing participation in groups | 306 | ||
| Concluding observations | 307 | ||
| Part 7 Maintenance and management of flare-ups | 308 | ||
| Introduction | 308 | ||
| Advice to the patient and family | 309 | ||
| Advice to the referring agent and general practitioner | 310 | ||
| To follow up or not? | 311 | ||
| Auditing the programme | 312 | ||
| Management of 'cries for help' | 313 | ||
| Post-PMP support groups | 314 | ||
| Accessing return to work post PMP | 315 | ||
| Conclusion | 315 | ||
| References | 315 | ||
| Part 8 Conclusions | 316 | ||
| Consistency of approach | 316 | ||
| The advantage of developing explicit 'house rules' | 316 | ||
| Monitoring progress | 317 | ||
| The importance of individual reviews | 317 | ||
| The setting of task assignments | 317 | ||
| Group review | 317 | ||
| The end of the programme | 318 | ||
| The importance of careful documentation and discharge letters | 318 | ||
| Concluding observations on tertiary interdisciplinary PMPs | 318 | ||
| Section Five: Occupational perspectives | 321 | ||
| Chapter 12. Economic and medicolegal influences on pain and disability | 323 | ||
| Introduction | 323 | ||
| The economic impact of pain and disability | 323 | ||
| Psychological impact of economic factors on the individual with pain | 325 | ||
| The special influence of compensation and litigation | 326 | ||
| Methods used in the assessment of lying, faking and deception | 328 | ||
| Psychological and psychiatric evaluation of painful personal injury | 334 | ||
| The context of deception and malingering | 335 | ||
| Deception | 336 | ||
| Malingering | 336 | ||
| Exaggeration | 337 | ||
| Conclusion | 340 | ||
| References | 340 | ||
| Chapter 13. Psychological perspectives on work | 343 | ||
| Historical perspective | 343 | ||
| Stress and work | 344 | ||
| Traditional perspectives on musculoskeletal symptoms and injury | 346 | ||
| Psychological features of work | 348 | ||
| The psychological effects of work absence | 349 | ||
| Occupational factors and recovery from injury: a conceptual framework | 349 | ||
| Conclusions and preliminary recommendations | 351 | ||
| References | 352 | ||
| Chapter 14. Pain and work: individually focused interventions | 355 | ||
| Introduction | 355 | ||
| The nature of clinical and occupational rehabilitation | 356 | ||
| Clinical interventions and RTW | 356 | ||
| Interventions with a clear occupational focus | 359 | ||
| Targeting risk factors for work disability | 361 | ||
| Conclusions | 365 | ||
| References | 366 | ||
| Chapter 15. Pain and work: organisational perspectives | 369 | ||
| Introduction | 369 | ||
| Black flags: economic and organisational obstacles to RTW | 371 | ||
| Organisational structures and processes | 373 | ||
| Organisation management and work absence | 375 | ||
| Managing organisational absence | 378 | ||
| The role of health management policies and RTW programmes | 381 | ||
| Targeting workplace or system-related psychosocial risk factors | 383 | ||
| Recommendations for action | 384 | ||
| Conclusions | 386 | ||
| References | 388 | ||
| Section Six: Conclusions | 393 | ||
| Chapter 16. Conclusions | 395 | ||
| New models of pain and disability: opportunities for pain management | 395 | ||
| New understandings of chronicity | 396 | ||
| Determinants of consulting | 397 | ||
| Role of psychological assessment | 397 | ||
| New types of interventions | 397 | ||
| Clearer understanding of potential for pain management in different settings | 397 | ||
| New vehicles for service delivery | 399 | ||
| Research agenda | 401 | ||
| Policy/political agenda | 402 | ||
| Recommendations: where now for pain management? | 404 | ||
| References | 406 | ||
| Index | 409 |