PAIN IN ARTHRITIS AND MUSCULOSKELETAL DISORDERS - THE ROLE OF COPING SKILLS TRAINING AND EXERCISE INTERVENTIONS

There is growing recognition of the limitations of conventional, biome dical approaches to the management of pain in individuals having arthr itis and musculoskeletal disorders. This article provides an overview of newly developed biopsychosocial approaches to the management of pai n in this population. The presentation is divided into three sections. In the first section, a biopsychosocial model of pain is presented. T his model highlights the role that biological factors (eg., disease se verity, comorbid conditions), cognitive-behavioral factors leg., thoug hts, emotions, and behaviors), and environmental factors (eg., spouse or family responses to pain behavior) can play in influencing the pain experience. in the second section, we provide an overview of two newl y developed treatment protocols based on the biopsychosocial model of pain: a pain coping skills training protocol and an exercise training protocol. Practical aspects of implementing these protocols are illust rated by highlighting how they are applied in the management of patien ts having persistent osteoarthritic pain. In the final section of the article, we pinpoint several important future directions for research in this area. Future studies need to explore the utility of combining pain coping skills and exercise training protocols. In addition, there is a need to identify variables that predict patients' response to bi opsychosocial treatments.