From the Guidelines
Pain misinterpretation should be addressed by educating patients on the neuroscience of pain, emphasizing that chronic gastrointestinal pain is real, perceived, and modifiable, as stated in the 2021 clinical practice update by the American Gastroenterological Association 1. To effectively manage pain misinterpretation, it is crucial to understand the complex interaction between nerve impulses, brain processes, and psychological contexts that perpetuate pain.
- Providers should master patient-friendly language to explain the pathogenesis of pain, leveraging advances in neuroscience and behavioral science, as highlighted in the 2021 study 1.
- Patients should be informed that chronic gastrointestinal pain is not just a product of peripheral factors but also of higher-order brain processes that can amplify the painful experience.
- The Fear-Avoidance model of pain can help explain why some people experience more pain than others despite similar diagnoses and can instill hope for improvement with a change in approach to pain management. Key aspects to focus on include:
- Pain neuroscience education to help patients understand that pain is perceived and modulated in the brain, and it is not always a direct indicator of tissue damage.
- Cognitive-behavioral therapy to address psychological inflexibility, pain catastrophizing, and hypervigilance.
- Gradual exposure to feared movements or activities to recalibrate the pain response system.
- Mindfulness meditation to improve pain perception and reduce stress.
- Medication management, such as low-dose amitriptyline or duloxetine, may be considered under the guidance of a healthcare provider to modulate pain signals. By addressing pain misinterpretation through a comprehensive approach that includes education, psychological support, and gradual exposure, patients can better understand their pain and work towards improving their quality of life, as suggested by the latest clinical practice update 1.
From the Research
Pain Misinterpretation
- Pain is a complex and subjective experience that can be influenced by various factors, including biological, physical, and psychological stimuli 2.
- The assessment and management of pain require a structured approach to identify the probable causes of pain and guide management, with interventions that can be varied and multimodal 3.
- Effective pain management is crucial to improve the quality of life of patients, and nurses play a vital role in assessing and managing pain 4, 3.
- The initial recognition of pain is a critical step in providing high-quality nursing care, and barriers to recognition can negatively affect pain management 4.
- Pain can be classified into different types, including acute and chronic pain, and each type requires a unique approach to management 2, 3.
Factors Influencing Pain Perception
- Comorbidities, such as back pain, hypertension, headache, depression, and sleep disorders, can influence pain perception and management 5.
- Medications, including opioids, benzodiazepines, sleep disorder drugs, and muscle relaxants, can also impact pain management 5, 6.
- The dose and duration of medication can affect pain management, and individualized treatment plans are essential to optimize pain control 5, 6.
Assessment and Management Strategies
- Formal pain assessment tools can support optimal patient care and guide management decisions 4, 3.
- A person-centered approach to care, which takes into account the patient's subjective experience of pain, is essential for effective pain management 3.
- Multimodal interventions, including pharmacological and non-pharmacological strategies, can be used to reduce pain and improve quality of life 2, 3.