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VUB research recommends new approach to chronic pain
Focus on psychosocial factors and active treatment
Chronic pain is one of the most challenging problems facing society. It has a significant impact on the daily lives of 23% of the population, and the care given to patients experiencing persistent pain is often not appropriate. The Pain in Motion research group at the Vrije Universiteit Brussel (VUB) focuses on improving healthcare providers’ understanding and treatment of persistent pain. As part of a project with Belgium’s FPS Public Health, they have developed a training course on chronic pain that gives care providers a framework for better treatment.
Around the world, many healthcare providers still take a traditional biomedical approach to pain, expecting persistent pain to be directly linked to physical damage. As a result, patients are often advised to avoid pain as much as possible to prevent further damage to the body, which often involves bed rest.
However, the relationship between damage and pain is often not present in the case of chronic pain, making this advice largely detrimental. Research shows that patient care that addresses biomedical, psychological and social factors leads to better outcomes.
“Pain is normally considered to be the body’s protection mechanism,” says Wouter Munneke, PhD researcher at Pain in Motion. “But with chronic pain, the body is over-protective, meaning we experience pain without the threat of actual harm. Psychological and social factors play an important role. Anxiety is a good example of this. If we’re anxious or think that something is ‘dangerous’, we are likely to be alerted through experiencing pain, like a child who is afraid of an injection. Because of this, treatment should focus not on physical damage – which is often not present or has already healed – but on underlying factors that keep the body overprotective.”
In the current treatment approach, there is too much focus on underlying damage and not enough focus on psychosocial factors. Treatment is often insufficient.
The VUB researchers gave training to more than 500 care providers from various disciplines – physiotherapists, GPs, occupational therapists, psychologists, pharmacists and nurses – in Antwerp, Ghent, Brussels, Namur and Liège. In those sessions, they explored whether healthcare providers looked at pain differently when taking into account biological, psychological and social factors.
The results were striking: the course greatly improved knowledge and perceptions of pain, and the advice to avoid pain and the recommendation of bed rest was replaced by a focus on action and educating patients about the issues, allowing them to better cope with pain symptoms.
The researchers stress that these findings are not intended as a reproach to the healthcare sector, but rather as a call for wider knowledge dissemination on the complexity of pain. “It’s essential that this approach to pain is better integrated into the healthcare sector, training and wider society,” says Munneke.
Approximately 33-49% of all GP consultations are by patients with persistent pain, but pain is very little discussed within training for professionals, leading to a lack of knowledge and expertise. Munneke: “Our goal is to bring about a culture shift in how we understand and treat pain, in training and among care providers, because patients with chronic pain have the right to better care.” The FPS Public Health is also committed to this.
Pain in Motion provides its chronic pain training materials and e-learning modules to healthcare providers and organisations free of charge. It also offers a brochure about pain and videos for patients to help them better understand pain. These initiatives are an important step towards a more holistic approach to pain, focused on improving patient well-being.
Contact
Wouter Munneke
PhD researcher Pain in Motion
E-mail: wouter.munneke@vub.be
Telefoon: +31655555440
Koen Stein
