Article

The etiology of chronic pain-related disability is not fully understood,
particularly from a clinical perspective. Investigations to date have identified
risk factors and elucidated some important processes driving the development of
persistent pain problems. Yet this knowledge and its application are not always
accessible to practicing physical therapists or other clinicians.
This article
aims to summarize the main psychological processes involved in the development of
chronic pain disability and to derive some guidelines for treatment and future
research. To this end, the focus is on the paradox of why coping strategies that
are helpful in the short term continue to be used even when-ironically-they
maintain the problem in the long term. To aid in summarizing current knowledge, 4
tenets that elucidate the etiology of chronic pain are described. These tenets
emphasize that chronic pain disability is a developmental process over time,
contextual factors set the stage for this development, underlying transdiagnostic
psychological factors fuel this development, and the principles of learning steer
the development of pain behaviors. With these tenets, an explanation of how a
chronic problem develops for one person but not another is provided. Finally,
hypotheses that can be empirically tested to guide clinical application as well
as basic research are generated. In conclusion, understanding the psychological
processes underlying the etiology of chronic pain provides testable ideas and a
path forward for improving treatment interventions.

Langue : ANGLAIS