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Lookup NU author(s): Dr Chris PenlingtonORCiD,
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Aim: To understand current psychological theories of pain, their background and the current state of the science. Objectives: Explain the limitations of the medical model of care when working with persistent orofacial pain.Understand how the application of psychological theory to persistent pain has developed over time. Describe the difference between theories which focus on potential mechanisms of pain and those which focus on the function of pain. Abstract: While pain has traditionally been understood within a medical model which equates pain to tissue damage or disease this understanding is not consistent with everyday observations of pain or with clinical examples of persistent pain where there is often very little correlation between pain experienced and physical findings.This article considers psychological and multidimensional theories of pain which are described within the historical context within which they were developed, including behavioural, cognitive, contextual and functional theories. Research into the multifactorial nature of persistent pain has tended to focus on mechanisms of pain development and maintenance or on the function of pain. Psychological approaches which have focused on mechanism traditionally use disability, mood and quality of life measures to assess outcome, claiming little or no impact on pain intensity itself. By contrast, functional approaches include an explicit goal of reducing pain intensity which is therefore measured as a key treatment outcome. Strong evidence exists from a range of sources of the important contribution of psychological and social factors to the experience of pain. However, evidence is still lacking about the specific mechanisms of change that are targeted by biopsychosocial interventions and about what treatment approach is likely to work best for who.
Author(s): Penlington C, Urbanek M, Barker S
Publication type: Article
Publication status: Published
Journal: Primary Dental Journal
Print publication date: 01/02/2019
Online publication date: 19/02/2019
Acceptance date: 25/01/2019
ISSN (print): 2050-1684
ISSN (electronic): 2050-1692
Publisher: Faculty of General Dental Practice