Controlled clinical trial of desensitization to chronic pain

据估计，新南威尔士州17.1%的男性和20.0%的女性患有慢性疼痛。慢性疼痛患者是卫生服务的主要使用者，他们就诊频繁，药物消耗量高。新南威尔士州最近的一项以人口为基础的研究发现，78%的疼痛患者在过去6个月里至少咨询过一位保健医生，71%的患者正在服用常规口服镇痛药物。慢性疼痛造成的残疾往往与较高程度的痛苦和使用医疗保健服务有关。不幸的是，目前对大多数慢性疼痛没有持久的治疗方法，大多数患有这些疾病的人被告知他们必须学会忍受持续的疼痛。教慢性疼痛患者忍受疼痛的最有效方法之一是认知行为疗法（CBT）干预。但是，尽管许多人发现这些方法很有帮助，但很大一部分病例仍然被它们的痛苦所困扰。这使得他们有更高的复发风险，需要进一步的治疗。如果这群疼痛患者能够被教导更有效的方法来最小化他们与疼痛相关的痛苦，他们的整体功能和长期生活质量目标就可以最大化。这项研究有可能大大改善患有致残慢性疼痛的痛苦患者的预后，传统上这是一个非常棘手的群体。这项研究对预防与持续疼痛相关的残疾也有重要意义。如果成功，它可能会改变许多保健专业人员建议患者应对慢性疼痛的方式，特别是在使用放松和分散注意力技术的常见方式以及使用减轻疼痛的干预措施方面。这项研究是这些传统方法的第一次主要临床试验。

An estimated 17.1% of males and 20.0% of females in NSW report having chronic pain. Chronic pain sufferers are major users of health services, with frequent medical consultations and high pharmacological consumption. A recent NSW population-based study found that 78% of pain sufferers had consulted at least one healthcare practitioner in the previous 6 months about their pain, and 71% of those sampled were taking regular oral analgesic medications. Disability due to chronic pain is often associated with higher levels of distress and use of healthcare services. Unfortunately, at present there are no lasting curative treatments for most chronic pain conditions and most people with these conditions are told they have to learn to live with their ongoing pain. One of the most effective ways of teaching chronic pain sufferers to live with their pain are known as cognitive behavioural therapy (CBT) interventions. But even though many find these methods helpful, a significant proportion of cases remain distressed by their pain. This places them at higher risk of relapse and further treatment seeking. If this group of pain sufferers could be taught more effective ways of minimising their pain-related distress, their overall functional and long-term quality of life goals could be maximised. The study has the potential to achieve a major improvement in outcomes for distressed patients with disabling chronic pain, traditionally a very intractable group. The study would also have important implications for the prevention of disability associated with persisting pain. If successful, it could alter the ways in which many health professionals advise patients to cope with their chronic pain, especially in relation to the use of the common modalities of relaxation and distraction techniques, as well as the use of pain reducing interventions. The study represents the first major clinical test of an alternative to these traditional modalities.