The Journal of Pain Summary

Highlight from The Journal of Pain (Volume 19, No. 10, October 2018 Issue)

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Presurgery Acceptance and Commitment Therapy Shown Effective for Pain Control

Lilian Dindo, M. Bridget Zimmerman, Katherine Hadlandsmyth, Barbara StMarie, Jennie Embree, James Marchman, Tony Tripp-Reimer, Barbara Rakel

Orthopedic surgeries are often associated with high levels of postoperative pain, which over time can have a dramatic effect on daily functioning and overall quality of life. In recent years, attention has increasingly centered on identifying predictors of postoperative pain to facilitate early intervention and better pain management.

In a multicenter study, researchers studied 88 veterans undergoing painful orthopedic surgeries and sought to assess the efficacy of a 1-day, perioperative acceptance and commitment (ACT) therapy workshop to help prevent progression to postoperative chronic pain and opioid use. One half of the subjects were treated for pain as usual and the other half completed the ACT workshop. Pain levels and opioids use were measured up to 3 months following surgery.

Results showed that patients who participated in the 1-day ACT intervention reported greater pain reduction at 3 months after surgery and achieved pain and opioid cessation 9 days sooner than patients receiving standard pain treatments (42 days versus 51 days).

The authors concluded these promising results warrant further investigation in a larger clinical trial. They noted that ACT intervention before surgery for at-risk veterans has potential to change clinical practice from an emphasis on management of postoperative pain to prevention of chronic pain in at-risk individuals.