German researchers evaluate short-term cognitive pain management techniques for acute pain

Those who accept their pain condition are best able to tolerate pain, while distraction can be the way to lower pain intensity, according to research reported in The Journal of Pain, the peer review publication of the American Pain Society (www.americanpainsociety.org).

A team of German researchers evaluated the most common short-term cognitive pain management techniques for acute pain - acceptance, distraction and cognitive restructuring. They noted that little is known about the relative efficacy of acceptance strategies compared to other cognitive approaches, such as distraction and cognitive restructuring. The objective was to explore the differential short-term effects of these methods in a sample of 109 female students exposed to thermal mode experimental pain stimuli.

As an adjunctive pain treatment, acceptance is intended to disrupt the link between thoughts and behaviors so patients are willing to tolerate pain. The majority of experimental studies have shown that acceptance strategies are more effective at increasing pain tolerance than other pain regulation strategies.

In the study sample, distraction was used to shift attention away from pain stimulation to lessen pain intensity. With cognitive behavioral structuring, patients are trained to alter their appraisals of pain dysfunction in order to improve their ability to cope with pain. Proponents believe that restructuring pain-related thoughts may affect disability-related behavior, such as avoiding work or recreational activities in fear of pain.

Results of the study showed that acceptance led to increased pain tolerance relative to cognitive restructuring and distraction lowered pain intensity compared to acceptance. No significant differences were detected between distraction and acceptance with regard to pain tolerance. The authors concluded that cognitive restructuring was no different from distraction for increasing pain tolerance. They noted that from a clinical perspective knowledge about cognitive pain management strategies can be useful in gauging treatment outcomes and for refining the treatment of chronic pain.

SOURCE American Pain Society