‘More and more attention to the psychological side of pain’
More and more is known about the psychological side of pain. This allows for new possibilities in pain management, say pijnwetenschappers in the framework of the Week of the Pain.
Pain is not an objective phenomenon and depends partly on the experience of the patient. That insight is increasingly accepted and applied with the help of patients, says professor of Experimental Pain management Bert Joosten to NU.nl.
“Pain consists of two things: the pijnreactie and the pijngewaarwording. The pijnreactie is, for example, the withdrawal of the hand from burning. But the pijngewaarwording – how much pain someone experiences is subjective.”
The pijngewaarwording is highly dependent on psychological factors. “There is more and more evidence for,” says clinical psychologist Han Samwel, who as a psychotherapist patients with chronic pain deals with. “How one with pain to deal with, can become even heavier weigh in the experience of pain than the initial physical damage.”
Brain scans of patients suggest that pijnervaring from different mental angles is affected. “In pain, both emotional-, cognitive -, if gedragsgebieden active. On MRI-scans is to see that all of these brain regions in pain light up,” explains Samwel.
Joosten at the Maastricht UMC research into chronic pain after operations. “It turns out that fear is a predictive value. The more frightened the patient for surgery, the greater the chance of developing chronic pain afterwards. We develop the “better in, better out’treatment. So people better be an operation in, for example, by the fear to treat.”
Also examination of Samwel points out that fear of pain can keep it, just as impotence and excessive focus on the pain. Vice versa works optimism and acceptance understand pijnverzachtend. “We help people to not to oppose pijnervaring, but to accept it and then focus on what in life is important.”
Joosten points to fakirs who spijkerbedden. “They can have their pain mentally check. Another example: football players with an injury to play and the pain only after the end of the race feel.”
Both pijnonderzoekers see the attention to the psychological side of pain increase. “There has been a huge shift occurred. So today, in more and more pijnteams also a psychologist who meebeoordeelt and meebehandelt, as well as pijnverpleegkundigen” said Samwel.
That pain is partly ‘between the ears’ to hear patients initially do not like, know Joosten. “They interpret that as: I’m mentally not in order. But pain is now once partly in the head. People are becoming more open to it, but in the first instance, they would rather that the doctor they have a syringe.”
“People have usually not by how much influence they have,” adds Samwel. “They think that they not be otherwise than afraid or powerless. Only when they are with peers or social workers go to talk to that they hold up a mirror that realization.”
However, it is important to relieve pain not to psychologiseren: pain remains something that is physically felt, stressed Samwel. “But you have to be patient always any influence.”