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0:00
Hello. I'm Tamar Pincus.
I'm a professor of health
psychology at Royal
Holloway University of
London and I've been
studying pain for over 20 years.
Today, I'm going to be speaking
about the psychology of pain
as it relates to
musculoskeletal pain.
Most of the research will
be about low back pain
simply because this is the area
that has been covered in most depth,
but it does extend to other
conditions such as fibromyalgia,
sciatica, and others.
0:30
I'll be talking about
risk factors to moving
from a common complaint
like back pain
to chronic conditions
with a lot of disability.
I'm going to be covering some
of the interventions that
are currently offered and weighing
up the evidence for their efficacy.
And then I'm going to describe two
of the most common interventions,
CBT, Cognitive Behavioral Therapy,
and ACT, a less common one,
Acceptance and Commitment
Therapy, and I'm going
to explain how the two differ.
And I'm going to talk a little bit
towards the end about what we might
offer to which type of patient.
1:07
In order to find out what
psychological factors are
important in that move
towards chronicity,
we need to look at
prospective cohorts.
These are studies that measure a
whole load of factors at baseline
and then follow up people,
typically for 6 or 12 months, to try
and find out what
predicts poor outcome.
In order to do this, you have
to have some sort of idea
of what might predict bad outcome.
In other words, you need
to identify suspects.
You need to find good
measures of these suspects.
And we'll see later on
that some of the measures
are not as good as we
would like them to be.
You have to have a timeline.
You have to be sure that you measure
at baseline, in other words,
at early stages, typically less
than three weeks of back pain.
And you need to follow people
up typically at least twice
at early stages, such as 4 months
or 6 months, and then at 12 months.
The best studies
follow up for longer.
And we now have some
studies that follow
up patients for up to 10 years.
So we know quite a lot about
predictors of poor outcomes.
