Article

Conventional rehabilitation of patients with chronic pain is often not successful
and is frustrating for the treatment team. However, theoretical developments and
substantial advances in our understanding of the neurological aspects of chronic
pain are changing these experiences. Modern theoretical models of pain consider
pain to be a perceptual inference that reflects a "best guess" that protective
action is required. This article argues that keen observation and open and
respectful clinician-patient and scientist-clinician relationships have been
critical for the emergence of effective rehabilitation approaches and will be
critical for further improvements. The role in modern pain rehabilitation of
reconceptualizing the pain itself-by "Explaining Pain," careful and intentional
observation of the person in pain, and the strategic and constant communication
of safety-is emphasized.
It also is suggested that better understanding of the
neural mechanisms underpinning chronic pain has directly informed the development
of new therapeutic approaches, which are being further refined and tested.
Conventional pain treatment (where the clinician strives to find the
pain-relieving medication or exercise) or pain management (where the clinician
helps the patient to manage life despite unabating pain) is being replaced by
pain rehabilitation, where a truly biopsychosocial approach allows clinicians to
provide patients with the knowledge, understanding, and skills to reduce both
their pain and disability. A brief overview is provided of the key aspects of
modern pain rehabilitation and the considerations that should lead our
interaction with patients with chronic pain.
CI - (c) 2015 American Physical Therapy Association.

Langue : ANGLAIS