Nonpharmacologic Management of Pain

Behavioral and psychological interventions for pain management have often been included in patient care as a last resort, a place to turn to when biomedical interventions fail to yield sustained amelioration in pain symptoms. Such an approach disregards research which has long suggested that patient outcomes are improved when incorporating psychosocial variables in the conceptualization and treatment of chronic pain from the onset of care. The opioid epidemic in the US may have an unintended consequence of changing the perception of behavioral and psychological interventions as a last line of defense as clinicians look for treatments to fill the space vacated by narcotic medications. Successful implementation of biopsychosocial treatment pathways will require clinicians to have a solid understanding of the fundamentals of this approach to care. This presentation will provide a broad perspective on the role of psychology in the etiology, maintenance, and exacerbation of pain. Psychological variables associated with the chronification of pain will be discussed, including their associations with disability. An overview of cognitive behavioral interventions for pain, stress, and mood management will be presented along with literature supporting their use. Strategies for including psychological approaches in regular medical appointments will be shared to facilitate incorporation of such tools in localities with limited access to mental health. (Recorded at PAINWeek 2017)