Patient and Provider Beliefs About Pain
Low expectation of pain control on the part of patients and providers leads to poor pain control. Settling for any improvement is not enough. Patients state clearly that they are always going to have pain, always need to be on medication and always be limited because of this pain. Providers set low expectations of pain relief. Statements are made to patients that they will have to learn to live with their pain and the best they can hope is to manage it. The provider-patient relationship is a powerful example of the social synapse, the connection between people involving mirror neurons and the highest Associational centers of the brain. As such, the words passed from provider to patient strongly determine patient beliefs. As belief centers in the sensory part of the brain become dominated by the expectation of pain, nerve cells in those belief centers are taken over by pain processing. The belief in the inevitability of pain expands the pain map in the sensory cortex where beliefs are born.
The process of healing starts by embracing the core belief that patients can be pain free. Providers need to believe that their patients can be free of persistent pain. They must continue to try new approaches to achieve this goal. The traditional model of care changes here. Patients become partners with their providers, rather than passive recipients of care.