A lot has been written about psychosocial factors and their effect on chronic pain. Few studies have defined the factors that are important and at what level. In fact, studies that have taken place have looked at different factors in different situations, resulting in little consistency in the findings and trial outcomes.
In this topical review, the authors discuss the need for well-controlled studies to determine consistent findings. While doctors know that there is a connection between pain and psychosocial, behavioral and social factors, they don’t know much about the actual connections. The authors say that the lack of definitions, or poorly defined definitions, of psychosocial factors may be partly to blame. By having poorly defined parameters with which to work, researchers can choose what they will follow and how.
Many things can affect psychosocial factors, including socio-economic status, workplace (work and actual environment), personal relationships, and access to professional help. Some studies have investigated one or two of the factors, but no study has been found that investigates them all. This hasn’t allowed the researchers to get a full picture of all factors.
A study should define and explain exactly what happened, even if there are multiple causes, and outcomes. It should identify the risk factor levels and determine data that needs to be collected at each level of influence. Each study should follow the same criteria to see if they find similar outcomes.
The better the model with which to work, the easier it would be for the researchers to identify important elements and findings from the studies. Researchers need to pay attention to the measurement of psychosocial risk factors. For example, if researchers are studying workplace stress, there is not only the actual stress that needs to be evaluated but also the workers’ perception of the stress. What is stressful to one person may not be to another.
When discussing the evaluation and treatment of pain, people in different roles (patient, spouse, doctor, employer) have different views of pain. This can affect the understanding of pain and the causes.
The authors conclude that further study is required to identify and clarify what is to be treated if and when psychological factors are taken into consideration. Researchers need a clearer model and n consistency about what is being tested. Specific parameters need to be adhered to to then allow a testable hypothesis when applied to other areas.
If these are taken into account and put into practice, doctors may be better able to see and understand the pathways of causal factors that are involved in developing pain, resulting in better treatment.