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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 …
Contributors BTS, CGM, ACT and JHM were involved in the conception, design and interpretation of data. BTS and QL performed the data analysis. BTS was responsible for the main writing and drafting of the article. CGM, JHM and ACT revised critically for important intellectual content. All authors approved the final version to be submitted.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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