According to Marks et al. (2006) there are several strategies pertaining to the management of pain which include behavioral, cognitive, cognitive-behavioral, physical, and pharmacological approaches. Behavioral strategies encompass components of both classical and operant conditioning, graded exercise, relaxation, biofeedback and autogenic training. Specifically, conditioning parameters for behavioral approaches to pain management may include the inclusion of positive and negative reinforcement. However, these behavioral methodologies have shown to be much more applicable to short-term success than contingent success (Marks et al., 2006). Furthermore, while conditioning factors, graded exercise strategies, and relaxation and biofeedback prove to be beneficial, it is believed that they are most effective when used in congruence with other pain management methods.
Cognitive Methods of Pain Control
Cognitive strategies take an intrapsychic approach to managing pain and promote an identification and conceptualization of thoughts and their relations to experienced pain. Cognitive strategies offer pain management in the form of cognitive coping skills such as distraction, meditation, imagery, and positive self-talk (Marks et al., 2006). While these strategies stand to benefit one’s sense of self-efficacy, preoccupy and distract the mind with pleasant thoughts, and promote a relaxed state of mind, it is believed that a sole focus of controlled cognition directed toward uncontrolled pain can diminish valued aspects of a person’s life (Marks et al., 2006).
Cognitive Behavioral Therapy and Pain Control
Cognitive-behavioral therapy has proven to be a significantly effective tool when it comes to pain management as well as various other disorders such as anxiety, PTSD, depression, and complex disorders (Fisher et al., 2006). Cognitive-behavioral approaches to pain management mesh cognitive and behavioral strategies into a two-pronged plan of attack of which promotes intrapsychic coping strategies as well as forms of conditioning and reinforcement with a separate emphasis on stress management.
Physical Approaches to Pain Control
Physical approaches to pain management are heavily concerned with sensory manipulation and control. These strategies consist of surgical procedures and forms of physiotherapy which involve severing fibers to cease pain signal transmission (surgery) and a promotion of increased function and stabilized mobility (physiotherapy) to satisfy cognitive requisites of self-efficacy as well as physical considerations such as safe mobility (Pope, 2009). Unfortunately, Marks et al. (2006) posit that while such strategies show substantial benefits for acute pain, they are much more ineffective for chronic pain.
Pharmacological Approaches to Pain Control
Lastly, pharmacological approaches utilize the prescription of various analgesics and anesthetics to treat pain. While pharmacological strategies for pain management are extremely effective for both acute and chronic pain, the potential risk of addiction, the promotion of self-medicating, and the societal/legal controversy present (such as the use of cannabinoids to treat symptoms of cancer) all create deleterious downsides to this approach (Marks et al., 2006).
References
Fisher, J.E., Hayes, L.J., Hayes, S.C., Henderson, D.A., O’Donohue, W.T. (2001). A History of The Behavioral Therapies : Founders’ Personal Theories. Reno, NV: Context Press.
Marks, D. F., Murray, M., Evans, B., Willig, C., Woodall, C. & Sykes, C. M. (2006). Health Psychology: Theory, Research, and Practice. London: Sage.
Pope, C. (2009). Recovering mind and body: a framework for the role of physiotherapy in mental health and well-being. Journal of Public Mental Health, 8(2), 36-39. Retrieved from EBSCOhost.
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