Background

Beliefs about the body and pain play a powerful role in behavioural and emotional responses to musculoskeletal pain. What a person believes and how they respond to their musculoskeletal pain can influence how disabled they will be by pain. Importantly, beliefs are modifiable and are therefore considered an important target for the treatment of pain-related disability. Clinical guidelines recommend addressing unhelpful beliefs as the first line of treatment in all patients presenting with musculoskeletal pain. However, many clinicians hold unhelpful beliefs themselves; while others feel ill-equipped to explore and target the beliefs driving unhelpful responses to pain. As a result, clinicians may reinforce unhelpful beliefs, behaviours and resultant disability among the patients they treat.

Methods

To assist clinicians, in Part 1 of this paper we discuss what beliefs are; how they are formed; the impact they can have on a person's behaviour, emotional responses and outcomes of musculoskeletal pain. In Part 2, we discuss how we can address beliefs in clinical practice. A clinical case is used to illustrate the critical role that beliefs can have on a person's journey from pain and disability to recovery.

Conclusions

We encourage clinicians to exercise self-reflection to explore their own beliefs and better understand their biases, which may influence their management of patients with musculoskeletal pain. We suggest actions that may benefit their practice, and we propose key principles to guide a process of behavioural change.

中文翻译：

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关于身体和疼痛的信念：在肌肉骨骼疼痛管理中的关键作用。

背景

关于身体和疼痛的信念在对肌肉骨骼疼痛的行为和情感反应中起着重要作用。一个人的信仰以及对肌肉骨骼疼痛的反应方式会影响他们因疼痛而变得残疾的程度。重要的是，信念是可以改变的，因此被认为是治疗与疼痛相关的残疾的重要目标。临床指南建议将无助信念作为所有出现肌肉骨骼疼痛的患者的第一线治疗方法。但是，许多临床医生自己持有无益的信念。而其他人则感到缺乏能力去探索和针对那些导致无助于缓解疼痛的信念。结果，临床医生可能会在他们所治疗的患者中强化无助的信念，行为和随之而来的残疾。

方法

为了帮助临床医生，在本文的第1部分中，我们讨论了什么是信念。它们是如何形成的；他们可能对一个人的行为，情绪反应和肌肉骨骼疼痛的后果产生影响。在第2部分中，我们讨论了如何解决临床实践中的信念。临床案例用于说明信念在从痛苦，残疾到康复的整个过程中所起的关键作用。

结论

我们鼓励临床医生进行自我反思，以探索自己的信念并更好地理解自己的偏见，这可能会影响他们对肌肉骨骼疼痛患者的治疗。我们提出了可能有益于他们的实践的行动，并且提出了指导行为改变过程的关键原则。