Browsing by Author "Juntunen, Heidi"

Chronic pain is a disabling condition with remarkable economic costs and great resistance to treatment. Therefore, it is important to find new methods to recognize patients with high risk of developing chronic pain and to prevent the transition to chronicity. The purpose of this review is to present and evaluate the evidence of cognitive–behavioral interventions as preventive care for chronic pain. The fear–avoidance model of pain suggests that a minority of people with acute pain develop a persistent disability through avoidance behavior thriven by cognitive factors such as pain catastrophizing, fear of movement and false fear–avoidance beliefs. Indeed, psychological factors have been shown to predict the development of chronic pain even better than biomedical factors. Cognitive–behavioral interventions targeting these risk factors appear to be useful in preventing chronic pain and especially in pain-related work absenteeism. It is however unclear whether the positive effects of cognitive–behavioral interventions are mediated through the change in psychological risk factors or rather some other factors, such as therapeutic rapport or peer support that positively affect commitment to treatment. It is important to develop standardized treatment protocols in the future. The effect of intervention timing and the level of psychological risk on the preventive efficacy of cognitive–behavioral interventions should also be further studied. Developing more accurate screening tools to recognize patients with elevated risk of chronic pain in primary care is also crucial for efficient preventive care of pain conditions. In addition to work absenteeism, more attention should be paid to the effects of these early interventions on pain symptoms and patients’ quality of life.