The establishment, maintenance, and adaptation of high and low impact chronic pain: a framework for biopsychosocial pain research.

Christopher Eccleston; Emma Begley; Hollie Birkinshaw; Ernest Choy; Geert Crombez; Emma Fisher; Anna Gibby; Rachael Gooberman-Hill; Sharon Grieve; Amber  Guest; Abbie Jordan; Amanda Lillywhite; Gary J Macfarlane; Candida S. McCabe; John McBeth; Anthony E Pickering; Tamar Pincus; Hannah M Sallis; Samantha Stone; Danielle Van der Windt; Diego Vitali; Elaine Wainwright; Colin Wilkinson; Amanda C. de C Williams; Anica Zeyen; Edmund Keogh

doi:10.1097/j.pain.0000000000002951

The establishment, maintenance, and adaptation of high and low impact chronic pain: a framework for biopsychosocial pain research.

Christopher Eccleston, Emma Begley, Hollie Birkinshaw, Ernest Choy, Geert Crombez, Emma Fisher, Anna Gibby, Rachael Gooberman-Hill, Sharon Grieve, Amber Guest, Abbie Jordan, Amanda Lillywhite, Gary J Macfarlane, Candida S. McCabe, John McBeth, Anthony E Pickering, Tamar Pincus, Hannah M Sallis, Samantha Stone, Danielle Van der WindtDiego Vitali, Elaine Wainwright, Colin Wilkinson, Amanda C. de C Williams, Anica Zeyen, Edmund Keogh

Research output: Contribution to journal › Article › peer-review

4 Citations (SciVal)

Abstract

We present a framework for the study of states of chronic pain and transitions between those states. We capture in the framework the dynamic nature of pain: people live with pain that changes over time. First, we offer definitions of both acute and chronic pain, and explore the contextual considerations related to the common use of this temporal dichotomy. Second, we promote the importance of incorporating the impact pain has on a person’s life. Finally, we discuss the challenges and opportunities inherent in implementing this common approach. Our goal is to produce a framework for the study of the development, maintenance, and resolution of chronic pain. Whether a single brief event or a constant feature of life, pain interrupts to prioritise protection, interferes with activity, reduces quality of life, and can alter identity. [44] Protection is achieved by escape from harm, avoidance of perceived danger, withdrawal for respite and repair, and communication of incapacity and environmental risk; longer term protection is achieved by learning the cues for pain and injury. [53] From this perspective, pain is most usefully considered a need state, fundamentally a motivational drive to protect [49]. This approach centres our attention on the consequences of pain for the person in their context, on its duration and its impact.

Original language	English
Pages (from-to)	2143–2147
Number of pages	5
Journal	Pain
Volume	164
Issue number	10
Early online date	16 Jun 2023
DOIs	https://doi.org/10.1097/j.pain.0000000000002951
Publication status	Published - 1 Oct 2023

Bibliographical note

This work was supported by a joint and equal investment from UKRI [grant numbers MR/W004151/1 and MR/W026872/1] and the charity Versus Arthritis [grant number 22891] through the Advanced Pain Discovery Platform (APDP) initiative. For UKRI,
the initiative is led by the Medical Research Council (MRC), with support from the Biotechnology and Biological Sciences Research Council (BBSRC) and the Economic and Social Research Council (ESRC). No authors reported any conflicts of interest associated with this manuscript.

Data availability: There are no data associated with this manuscript.

Funding

This duration-impact framework has been developed in the context of a major UK research programme investigating the psychosocial determinants of high-impact chronic pain funded by the Advanced Pain Discovery Platform. The APDP has a focus on determining the causal influences on the onset and maintenance of high- and low-impact chronic pain. The consortium is exploring determinants of pain-state transitions using existing databases such as ALSPAC, ELSA, UK BIOBANK, HWW, and HEAF the synthesis of findings across published studies, and through new investigations.

Funders	Funder number
MRC	MR/W004151/1

Access to Document

10.1097/j.pain.0000000000002951Licence: CC BY

Psychosocial mechanisms of chronic pain
Kyprianou, A. (PI)
MRC
1/07/21 → 31/12/25
Project: Research council

Cite this

Eccleston, C., Begley, E., Birkinshaw, H., Choy, E., Crombez, G., Fisher, E., Gibby, A., Gooberman-Hill, R., Grieve, S., Guest, A., Jordan, A., Lillywhite, A., Macfarlane, G. J., McCabe, C. S., McBeth, J., Pickering, A. E., Pincus, T., Sallis, H. M., Stone, S., ... Keogh, E. (2023). The establishment, maintenance, and adaptation of high and low impact chronic pain: a framework for biopsychosocial pain research. Pain, 164(10), 2143–2147. https://doi.org/10.1097/j.pain.0000000000002951

Eccleston, C, Begley, E, Birkinshaw, H, Choy, E, Crombez, G, Fisher, E, Gibby, A, Gooberman-Hill, R, Grieve, S, Guest, A, Jordan, A , Lillywhite, A, Macfarlane, GJ, McCabe, CS, McBeth, J, Pickering, AE, Pincus, T, Sallis, HM, Stone, S, Van der Windt, D, Vitali, D, Wainwright, E, Wilkinson, C, de C Williams, AC, Zeyen, A & Keogh, E 2023, 'The establishment, maintenance, and adaptation of high and low impact chronic pain: a framework for biopsychosocial pain research.', Pain, vol. 164, no. 10, pp. 2143–2147. https://doi.org/10.1097/j.pain.0000000000002951

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abstract = "We present a framework for the study of states of chronic pain and transitions between those states. We capture in the framework the dynamic nature of pain: people live with pain that changes over time. First, we offer definitions of both acute and chronic pain, and explore the contextual considerations related to the common use of this temporal dichotomy. Second, we promote the importance of incorporating the impact pain has on a person{\textquoteright}s life. Finally, we discuss the challenges and opportunities inherent in implementing this common approach. Our goal is to produce a framework for the study of the development, maintenance, and resolution of chronic pain. Whether a single brief event or a constant feature of life, pain interrupts to prioritise protection, interferes with activity, reduces quality of life, and can alter identity. [44] Protection is achieved by escape from harm, avoidance of perceived danger, withdrawal for respite and repair, and communication of incapacity and environmental risk; longer term protection is achieved by learning the cues for pain and injury. [53] From this perspective, pain is most usefully considered a need state, fundamentally a motivational drive to protect [49]. This approach centres our attention on the consequences of pain for the person in their context, on its duration and its impact. ",

author = "Christopher Eccleston and Emma Begley and Hollie Birkinshaw and Ernest Choy and Geert Crombez and Emma Fisher and Anna Gibby and Rachael Gooberman-Hill and Sharon Grieve and Amber Guest and Abbie Jordan and Amanda Lillywhite and Macfarlane, {Gary J} and McCabe, {Candida S.} and John McBeth and Pickering, {Anthony E} and Tamar Pincus and Sallis, {Hannah M} and Samantha Stone and {Van der Windt}, Danielle and Diego Vitali and Elaine Wainwright and Colin Wilkinson and {de C Williams}, {Amanda C.} and Anica Zeyen and Edmund Keogh",

note = "This work was supported by a joint and equal investment from UKRI [grant numbers MR/W004151/1 and MR/W026872/1] and the charity Versus Arthritis [grant number 22891] through the Advanced Pain Discovery Platform (APDP) initiative. For UKRI, the initiative is led by the Medical Research Council (MRC), with support from the Biotechnology and Biological Sciences Research Council (BBSRC) and the Economic and Social Research Council (ESRC). No authors reported any conflicts of interest associated with this manuscript. Data availability: There are no data associated with this manuscript. ",

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AU - Birkinshaw, Hollie

AU - Choy, Ernest

AU - Crombez, Geert

AU - Fisher, Emma

AU - Gibby, Anna

AU - Gooberman-Hill, Rachael

AU - Grieve, Sharon

AU - Guest, Amber

AU - Jordan, Abbie

AU - Lillywhite, Amanda

AU - Macfarlane, Gary J

AU - McCabe, Candida S.

AU - McBeth, John

AU - Pickering, Anthony E

AU - Pincus, Tamar

AU - Sallis, Hannah M

AU - Stone, Samantha

AU - Van der Windt, Danielle

AU - Vitali, Diego

AU - Wainwright, Elaine

AU - Wilkinson, Colin

AU - de C Williams, Amanda C.

AU - Zeyen, Anica

AU - Keogh, Edmund

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PY - 2023/10/1

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N2 - We present a framework for the study of states of chronic pain and transitions between those states. We capture in the framework the dynamic nature of pain: people live with pain that changes over time. First, we offer definitions of both acute and chronic pain, and explore the contextual considerations related to the common use of this temporal dichotomy. Second, we promote the importance of incorporating the impact pain has on a person’s life. Finally, we discuss the challenges and opportunities inherent in implementing this common approach. Our goal is to produce a framework for the study of the development, maintenance, and resolution of chronic pain. Whether a single brief event or a constant feature of life, pain interrupts to prioritise protection, interferes with activity, reduces quality of life, and can alter identity. [44] Protection is achieved by escape from harm, avoidance of perceived danger, withdrawal for respite and repair, and communication of incapacity and environmental risk; longer term protection is achieved by learning the cues for pain and injury. [53] From this perspective, pain is most usefully considered a need state, fundamentally a motivational drive to protect [49]. This approach centres our attention on the consequences of pain for the person in their context, on its duration and its impact.

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DO - 10.1097/j.pain.0000000000002951

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JO - Pain

JF - Pain

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ER -

The establishment, maintenance, and adaptation of high and low impact chronic pain: a framework for biopsychosocial pain research.

Abstract

Bibliographical note

Funding

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Psychosocial mechanisms of chronic pain

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