Psychological Treatment in the Management of Pain following Musculoskeletal Injury.

Journal of orthopaedics and sports medicine Pub Date : 2025-01-01 Epub Date: 2025-03-31 DOI:10.26502/josm.511500191
Andre Aabedi, Vera Wang, Marcel P Fraix, Devendra K Agrawal
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Abstract

Musculoskeletal injuries are a leading cause of pain and disability, with many patients developing chronic pain. While traditional management focuses on physical treatments, psychological interventions have emerged as a complementary approach. This study examines the role of psychological treatments in pain management after musculoskeletal injury, their efficacy, and their integration with existing treatment strategies. A review of literature, including systematic reviews and meta-analyses, was conducted to assess the effectiveness of psychological treatments such as cognitive-behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), and pain neuroscience education (PNE). Studies on the impact of psychological distress on pain perception, circulating inflammatory biomarkers, and neuromuscular exercises were analyzed. Research indicates that psychological elements, particularly pain catastrophizing, anxiety, and depression, play crucial roles in determining both pain intensity and disability levels. Short-term improvements in pain intensity, functional capacity, and psychological well-being have been documented with CBT, MBSR, and PNE interventions. The integration of psychological approaches with physiotherapy demonstrates enhanced patient outcomes. Biological markers of inflammation, specifically CRP and IL-6, show potential as indicators of pain severity and treatment effectiveness. Notably, neuromuscular exercises have shown pain-reducing effects comparable to pharmaceutical interventions, though long-term efficacy data for psychological treatments remains variable. The integration of psychological interventions represents a significant advancement in musculoskeletal pain management, particularly in addressing the mental and emotional dimensions of pain experience. While current research supports their immediate benefits, additional investigation is necessary to determine long-term effectiveness and refine treatment approaches. Future research should emphasize individualized treatment protocols, technological integration, and robust longitudinal studies to maximize therapeutic outcomes.

肌肉骨骼损伤后疼痛的心理治疗。
肌肉骨骼损伤是疼痛和残疾的主要原因,许多患者会出现慢性疼痛。虽然传统的管理侧重于物理治疗,但心理干预已成为一种补充方法。本研究探讨了心理治疗在肌肉骨骼损伤后疼痛管理中的作用,它们的疗效,以及它们与现有治疗策略的整合。对包括系统回顾和荟萃分析在内的文献进行了回顾,以评估心理治疗的有效性,如认知行为疗法(CBT)、正念减压疗法(MBSR)和疼痛神经科学教育(PNE)。研究分析了心理困扰对疼痛感知、循环炎症生物标志物和神经肌肉锻炼的影响。研究表明,心理因素,特别是疼痛灾难化、焦虑和抑郁,在决定疼痛强度和残疾水平方面起着至关重要的作用。CBT、正念减压和PNE干预在疼痛强度、功能能力和心理健康方面的短期改善已被证实。心理方法与物理治疗的整合表明,提高了患者的治疗效果。炎症的生物标志物,特别是CRP和IL-6,显示出作为疼痛严重程度和治疗效果指标的潜力。值得注意的是,神经肌肉锻炼显示出与药物干预相当的减轻疼痛的效果,尽管心理治疗的长期疗效数据仍然存在变数。心理干预的整合代表了肌肉骨骼疼痛管理的重大进步,特别是在解决疼痛体验的精神和情感层面。虽然目前的研究支持它们的直接益处,但需要进一步的研究来确定长期有效性并改进治疗方法。未来的研究应强调个性化治疗方案、技术整合和可靠的纵向研究,以最大限度地提高治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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