A Biobehavioral Pain Hygiene Model: Narrative Review and Conceptualization. (July 2021)

• Record Type: Journal Article
• Authors: Saravanan, Anitha; Reagan, Louise
• Is Part Of: Topics in pain management. Volume 36:Number 12(2021)
• Page Start: 1
• Page End: 11
• Publication Date: 2021-07
• Subjects: Biobehavioral pain management -- Multimodal, Pain hygiene; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Pain -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; 616.0472
• DOI: 10.1097/01.TPM.0000756300.54102.46
• Languages: English
• ISSNs: 0882-5646

Abstract

Abstract : Objectives: Chronic pain frequently coexists with other distressing symptoms (depressive mood, sleep disturbance, fatigue, and stress) and maladaptive beliefs (fear avoidance and pain catastrophizing) that together are linked with increased pain severity and interference, poor function, and quality of life. Although a tremendous amount of research has been conducted to identify risk factors and treatment targets for managing pain, too often the strategies are not combined in a way to make them useful for daily multimodal application. The purpose of this narrative review is to examine the existing literature on the co-occurring symptoms and maladaptive beliefs, lifestyle, and socioenvironmental factors associated with chronic pain and the current nonpharmacological treatment strategies designed to help patients manage chronic pain. Methods: Literature databases PubMed/Medline, CINAHL, and PsycINFO were searched to review the evidence on treatment strategies that have evidence of effectiveness in managing chronic pain and co-occurring symptoms. Conceptual models of chronic pain and nonpharmacological pain management strategies were reviewed. Results: Evidence was found in support of cognitive-behavioral, lifestyle, and socioenvironmental factors and treatment strategies that are effective in managing chronic pain and co-occurring symptoms. The key factors identified and proposed include lifestyle factors (physical activity, diet, maintaining body weight, keeping a routine, and sleep habits), planned phases of activities (relaxing, pacing, and meditation at regular intervals), CBT strategies (stretching, breathing, meditation, and stress reduction), socioenvironmental factors (keeping a calm, peaceful, environment), and positive support system. On the basis of this evidence, a biobehavioral pain hygiene model is proposed that combines existing strategies in managing pain to make them useful for daily multimodal application and which may be used to integrate therapeutic interventions for chronic pain management. Discussion: Given the dearth of research on integrative multimodal pain management, this review and the biobehavioral pain hygiene model could drive future research in the management of chronic pain. Identification of the key strategies and combining them to be a useful multimodal application will be a first step toward identifying innovative methods that could help improve pain and function in patients with chronic pain.