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Pain-related psychological issues in hand therapy

HAMASAKI T; PELLETIER R; BOURBONNAIS D; HARRIS P; CHOINIERE M
J HAND THER , 2018, vol. 31, n° 2, p. 215-226
Doc n°: 187212
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.jht.2017.12.009
Descripteurs : AD8 - DOULEUR, DD86 - TRAITEMENTS / MAIN-DOIGTS

Pain is a subjective experience
that results from the modulation of nociception conveyed to the brain via the
nervous system. Perception of pain takes place when potential or actual noxious
stimuli are appraised as threats of injury. This appraisal is influenced by one's
cognitions and emotions based on her/his pain-related experiences, which are
processed in the forebrain and limbic areas of the brain. Unarguably, patients'
psychological factors such as cognitions (eg, pain catastrophizing), emotions
(eg, depression), and pain-related behaviors (eg, avoidance) can influence
perceived pain intensity, disability, and treatment outcomes. Therefore, hand
therapists should address the patient pain experience using a biopsychosocial
approach. However, in hand therapy, a biomedical perspective predominates in pain
management by focusing solely on tissue healing. PURPOSE OF THE STUDY: This
review aims to raise awareness among hand therapists of the impact of
pain-related psychological factors. METHODS AND RESULTS: This literature review
allowed to describe (1) how the neurophysiological mechanisms of pain can be
influenced by various psychological factors, (2) several evidence-based
interventions that can be integrated into hand therapy to address these
psychological issues, and (3) some approaches of psychotherapy for patients with
maladaptive pain experiences. DISCUSSION AND CONCLUSION: Restoration of sensory
and motor functions as well as alleviating pain is at the core of hand therapy.
Numerous psychological factors including patients' beliefs, cognitions, and
emotions alter their pain experience and may impact on their outcomes. Decoding
the biopsychosocial components of the patients' pain is thus essential for hand
therapists.
CI - Copyright (c) 2018 Hanley & Belfus. Published by Elsevier Inc. All rights
reserved.

Langue : ANGLAIS

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