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Psychological treatment for people with musculoskeletal pain 1
Published on July 30, 2015 35 min
Other Talks in the Series: Back Pain Management
Psychological treatment for people with musculoskeletal pain 2
- Prof. Tamar Pincus
- University of London, UK
Current thinking in pain medicine and some thoughts on back pain
- Dr. Nick Hacking
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
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.
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.
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.