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Dispelling the myth that chronic pain is unresponsive to treatment
  1. Bruno T Saragiotto1,
  2. Chris G Maher1,
  3. Adrian C Traeger2,
  4. Qiang Li1,
  5. James H McAuley2
  1. 1 The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
  2. 2 Neuroscience Research Australia (NeuRA), University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Bruno T Saragiotto, The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 3/50 Bridge Street, Sydney, NSW 2000, Australia; bruno.saragiotto{at}georgeinstitute.org.au

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Dispelling the myth that chronic pain is unresponsive to treatment

The contemporary management of chronic pain is strongly influenced by the belief that the non-pain consequences (eg, disability, emotional distress and reduced quality of life) play the dominant role in the experience of chronic pain.1 ,2 For example, treatments, such as education and biopsychosocial rehabilitation (ie, acceptance and commitment therapy), focus on reducing disability and distress, rather than pain intensity.

Growing use of non-pain-targeted approaches has seen the emergence of a view that treatments for chronic pain have little or no effect on pain, but have larger effects on non-pain factors such as disability.3 Patients are told to accept their pain and not to expect it to improve with treatment. This view is well illustrated in the quote:4 “Our best chronic-pain treatments don't produce an immediate or substantial change in pain intensity. Multimodal therapy… is not titrated to pain intensity but has a primary goal of reducing pain related distress, disability, and suffering. When it does that successfully, a reduction in pain intensity might follow—or acceptance might make the intensity of pain less important to a person's functioning and quality of life…We …

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