Do we need a new term to better understand the lives of pain patients?

As an osteopath in Hamburg, I meet people struggling with pain every day. Pain is a complex and profound experience that goes far beyond the purely physical. Previous concepts such as self-efficacy, pain-related anxiety and so-called catastrophizing try to capture these experiences, but often show an oversimplified picture of the reality of pain patients.in my contribution today, I would like to introduce a new approach developed by Fernandez and colleagues: the concept of“pain-related physical doubts“. This concept complements existing ideas and focuses on how pain can change our relationship with our own bodies.Body safety vs. body doubtAtits core is the idea of “body safety” – a deeply rooted sense that our bodies will function and adapt to challenges in the future. However, pain, injuries or diagnoses can turn this feeling into doubt. We begin to question whether and how our own body can function in the world.The three dimensions of bodily doubtLossof continuity: Life no longer feels as if it will go on as usual.Loss of transparency of the body: The body, which was previously in the background of our lives, suddenly becomes the center of our attention.Loss of trust in the body: Belief in the reliability and performance of our own body dwindles.These dimensions are often not directly tangible, but rather have a subliminal effect on our existence. They combine implicit and explicit beliefs and can be both adaptive and maladaptive.A new way of communicatingThisconcept is still in its infancy and needs to be further explored and developed. But it has the potential to fundamentally improve the way we communicate with each other and with our patients. It opens up new perspectives to better understand and treat the complex world of pain patients, and in my practice in Hamburg I already incorporate such considerations into my treatments. It is an exciting and important step towards better understanding the person behind the pain and supporting them holistically. Fernandez, A. V., J. Hartvigsen, S. Ravn, P. Stilwell, and A. Kongsted. “Reconceptualizing Pain-related Behavior: Introducing the Concept of Bodily Doubt”. European Journal of Pain, March 8, 2023, ejp.2105. https://doi.org/10.1002/ejp.2105.