- Preface
- List of Contributors
- List of abbreviations
- Chapter 1 Epidemiology of Back Pain, from the Laboratory to the Bus Stop: Psychosocial Risk Factors, Biological Mechanisms, and Interventions in Population-Based Research
- Chapter 2 Defining Chronic Pain by Prognosis
- Chapter 3 Genetic Factors Modulating Chronic Back Pain
- Chapter 4 Peripheral and Central Sensitization as Risk Factors of Low Back Pain
- Chapter 5 Dysfunction of the Hypothalamic–Pituitary–Adrenal Axis and Associated Stress Axes in the Development of Chronic Low Back Pain
- Chapter 6 Central Imaging of Pain and the Process of Chronicity
- Chapter 7 Structural Brain Changes in Patients with Chronic Back Pain
- Chapter 8 The Psychophysiology of Chronic Back Pain Patients
- Chapter 9 Electromyographically-Determined Muscular Fatigue in Low Back Pain
- Chapter 10 Unmasking the Deconditioning Paradigm for Chronic Low Back Pain Patients
- Chapter 11 Screening of Psychosocial Risk Factors (Yellow Flags) for Chronic Back Pain and Disability
- Chapter 12 Dispositional Fear, Anxiety Sensitivity, and Hypervigilance
- Chapter 13 Processes Underlying the Relation between Catastrophizing and Chronic Pain: Implications for Intervention
- Chapter 14 Fear-Avoidance as a Risk Factor for the Development of Chronic Back Pain and Disability
- Chapter 15 Endurance-Related Pain Responses in the Development of Chronic Back Pain
- Chapter 16 Cognitive Processing and Self-Pain Enmeshment in Chronic Back Pain
- Chapter 17 Significant Others in the Chronicity of Pain and Disability
- Chapter 18 Effects of Workers’ Compensation Systems on Recovery from Disabling Injuries
- Chapter 19 Work-Related Risk Factors for Transition to Chronic Back Pain and Disability
- Chapter 20 The Physician as Disability Advisor for Back Pain Patients
- Chapter 21 The Attitudes and Beliefs of Clinicians Treating Back Pain: Do They Affect Patients’ Outcome?
- Chapter 22 International Guidelines for the Diagnostics and Treatment of Acute, Subacute, and Chronic Back Pain
- Chapter 23 Engaging Patients in their Own Care for Back Care: The Role of Education and Advice in the Prevention of Chronic Pain and Disability
- Chapter 24 Motivational Issues in Pain Management
- Chapter 25 Pharmacotherapy of Low Back Pain
- Chapter 26 Reviewing the Concept of Subgroups in Subacute and Chronic Pain and the Potential of Customizing Treatments
- Chapter 27 Risk Factor-Based Cognitive-Behavioural Therapy for Acute and Subacute Back Pain
- Chapter 28 Physical Exercise Interventions and Low Back Pain
- Chapter 29 Contextual Cognitive-Behavioural Therapy for Chronic Pain (Including Back Pain)
- Chapter 30 Rehabilitation Programmes to Prevent Severely Disabling Chronic Back Pain
- Index
(p. 453) Motivational Issues in Pain Management
- Chapter:
- (p. 453) Motivational Issues in Pain Management
- Author(s):
Robert D. Kerns
, Mark P. Jensen
, and Warren R. Nielson
- DOI:
- 10.1093/med/9780199558902.003.0130
In this chapter we describe a motivational model of pain self-management and discuss its potential relevance in clinical situations. Briefly, according to the model, patients’ readiness to engage in pain self-management at the time of acute injury or illness, or even in the context of the emergence of unexplained pain, is expected to influence their coping responses to pain, their efforts to acquire and use new adaptive pain coping strategies, and ultimately, the course of pain and the likelihood that pain will resolve. We also describe methods for assessing motivation and readiness to adopt a self-management approach to chronic pain, methods for promoting motivation for pain treatment and for learning and implementing adaptive pain-coping skills, and strategies for tailoring pain treatment to patient preferences, interests, and expectations for treatment. We conclude the chapter with a more explicit discussion of the implications of the motivational model and motivational issues for understanding and addressing the process of transitioning from acute to chronic pain, and for preventing this transition.
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- Preface
- List of Contributors
- List of abbreviations
- Chapter 1 Epidemiology of Back Pain, from the Laboratory to the Bus Stop: Psychosocial Risk Factors, Biological Mechanisms, and Interventions in Population-Based Research
- Chapter 2 Defining Chronic Pain by Prognosis
- Chapter 3 Genetic Factors Modulating Chronic Back Pain
- Chapter 4 Peripheral and Central Sensitization as Risk Factors of Low Back Pain
- Chapter 5 Dysfunction of the Hypothalamic–Pituitary–Adrenal Axis and Associated Stress Axes in the Development of Chronic Low Back Pain
- Chapter 6 Central Imaging of Pain and the Process of Chronicity
- Chapter 7 Structural Brain Changes in Patients with Chronic Back Pain
- Chapter 8 The Psychophysiology of Chronic Back Pain Patients
- Chapter 9 Electromyographically-Determined Muscular Fatigue in Low Back Pain
- Chapter 10 Unmasking the Deconditioning Paradigm for Chronic Low Back Pain Patients
- Chapter 11 Screening of Psychosocial Risk Factors (Yellow Flags) for Chronic Back Pain and Disability
- Chapter 12 Dispositional Fear, Anxiety Sensitivity, and Hypervigilance
- Chapter 13 Processes Underlying the Relation between Catastrophizing and Chronic Pain: Implications for Intervention
- Chapter 14 Fear-Avoidance as a Risk Factor for the Development of Chronic Back Pain and Disability
- Chapter 15 Endurance-Related Pain Responses in the Development of Chronic Back Pain
- Chapter 16 Cognitive Processing and Self-Pain Enmeshment in Chronic Back Pain
- Chapter 17 Significant Others in the Chronicity of Pain and Disability
- Chapter 18 Effects of Workers’ Compensation Systems on Recovery from Disabling Injuries
- Chapter 19 Work-Related Risk Factors for Transition to Chronic Back Pain and Disability
- Chapter 20 The Physician as Disability Advisor for Back Pain Patients
- Chapter 21 The Attitudes and Beliefs of Clinicians Treating Back Pain: Do They Affect Patients’ Outcome?
- Chapter 22 International Guidelines for the Diagnostics and Treatment of Acute, Subacute, and Chronic Back Pain
- Chapter 23 Engaging Patients in their Own Care for Back Care: The Role of Education and Advice in the Prevention of Chronic Pain and Disability
- Chapter 24 Motivational Issues in Pain Management
- Chapter 25 Pharmacotherapy of Low Back Pain
- Chapter 26 Reviewing the Concept of Subgroups in Subacute and Chronic Pain and the Potential of Customizing Treatments
- Chapter 27 Risk Factor-Based Cognitive-Behavioural Therapy for Acute and Subacute Back Pain
- Chapter 28 Physical Exercise Interventions and Low Back Pain
- Chapter 29 Contextual Cognitive-Behavioural Therapy for Chronic Pain (Including Back Pain)
- Chapter 30 Rehabilitation Programmes to Prevent Severely Disabling Chronic Back Pain
- Index