Background: Pain is the most common
reason for physician consultation, it can interfere with the quality of life
and general functioning. The Global Burden of Disease study (2016) states that
pain and pain-related diseases are the leading cause of disability and disease
burden globally. Chronic pain over time can affect our mental health and
participation in daily activities viz our affecting general well-being.
Documented evidence has shown that simple medications are useful in 20% to 70%
of cases but psychological factors such as social support, hypnotic suggestion,
diversions such as excitement, or distraction can significantly affect pain’s
intensity. For holistic care, diversional therapy can be effective in managing
chronic pain, as it is a safe and cheap adjunct in managing chronic
conditions.Objective: To explore the effect of diversional therapy as an adjunct in managing chronic pain associated with depression.Methodology: This
study involves a case report of two patients been managed as a case of cervical spondylosis
with radiculopathy associated with depression. Both patients had diversional
therapy as an adjunct to conventional physiotherapy. Activity log and chart were developed to monitor
the compliance and pain was monitored using the numeric rating scale.Result: Diversional therapy has shown to be a safe adjunct in managing chronic
pain associated with depression. Diversional
therapy was successfully used as an intervention in decreasing pains of the
patients, improving their functioning and participation in
activities of daily living.Conclusion/Recommendation:
References
[1]
Alison, M. E., Blair, H. S., Kay, I. P., Cairns, S., & Alastair, W. C. T. (1999). Epidemiology of Chronic Pain in the Community. The Lancet, 354, 1248-1252. https://doi.org/10.1016/S0140-6736(99)03057-3
[2]
Al-Tamimi, Y. Z., Guilfoyle, M., Seeley, H., & Laing, R. J. (2013). Measurement of Long-Term Outcome in Patients with Cervical Spondylotic Myelopathy Treated Surgically. European Spine Journal, 22, 2552-2557. https://doi.org/10.1007/s00586-013-2965-4
[3]
Asmundson, G. J. G., Norton, G. R., & Allerdings, M. D. (1998). Posttraumatic Stress Disorder and Work-Related Injury. Journal of Anxiety Disorder, 12, 57-69. https://doi.org/10.1016/S0887-6185(97)00049-2
[4]
Asmundson, G., Gomez-Perez, L., Richter, A., & Carleton, R. N. (2014). The Psychology of Pain: Models and Targets for Comprehensive Assessment. In Chapter 4 Hubert van Griensven’s Pain: A Text Book for Health Care Professionals (pp. 35-48). Amsterdam: Elsevier.
[5]
Aweke, Z., Seyoum, F., Shitemaw, T., & Doba, D. (2020). Comparison of Preemptive Paracetamol, Paracetamol-Diclofenac & Paracetamol-Tramadol Combination of Postoperative Pain after Elective Abdominal Surgery under General Anesthesia, Ethiopia: A Randomized Control Trial Study. BMC Anesthesiology, 20, Article No. 191. https://doi.org/10.1186/s12871-020-01115-6
[6]
Binder, A. I. (2007). Cervical Spondylosis and Neck Pain: Clinical Review. BMJ, 334, 527-531. https://doi.org/10.1136/bmj.39127.608299.80
[7]
Elizabeth, C. V. (2012). Effectiveness of Computer Assisted Diversional Therapy on Pain and Behavioural Responses during Veni Puncture Procedures among Preschool Children Attending OPD in Masonic Hospital at Coimbatore. Chennai: The Tamil Nadu Dr.M.G.R. Medical University. http://repository-tnmgrmu.ac.in/id/eprint/3610
[8]
Eric, L. D. (2012). Pain Processing in the Human Nervous System: A Selective Review of Nociceptive and Biobehavioural Pathways. Primary Care, 39, 561-571. https://doi.org/10.1016/j.pop.2012.06.013
[9]
Farzaneh, M., Parvaneh, M., Behrooz, D., & Mohammad, A. A. (2011). The Effect of “Mindfulness Meditation for Pain Management” on the Severity of Perceived Pain and Disability in Patients with Chronic Pain. Salmand Iranian Journal of Ageing, 6. http://salmandj.uswr.ac.ir/article-1-378-en.html
[10]
Geert, C., Johannes, W. V., Peter, H. T. G., & Roeland, L. (1999). Pain-Related Fear Is More Disabling than Pain Itself: Evidence on the Role of Pain-Related Fear in Chronic Back Pain Disability. Pain, 80, 329-339. https://doi.org/10.1016/S0304-3959(98)00229-2
[11]
Hans-George, K., Dominic, A., Eli, A., Stefano, C., Beverly, C., Flaminia, C. et al. (2015). A Holistic Approach to Chronic Pain Management That Involves All Stakeholders: Change Is Needed. Current Medical Research and Opinion, 31, 1743-1754. https://doi.org/10.1185/03007995.2015.1072088
[12]
Hassed, C. (2013). Mind-Body Therapies: Use in Chronic Pain Management. Australian Family Physician, 42, 112-117.
[13]
Heller, J. G. (1992). The Syndromes of Degenerative Spine Disease. Orthopedic Clinics of North America, 23, 381-394.
[14]
Howard, G. B., Alan, G. W., Matt, S. B. A., Tracy, W. B. A., Jody, M. C., & Carl, L. R. (2011). Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United States. Pain Medicine, 12, 657-667. https://doi.org/10.1111/j.1526-4637.2011.01075.x
[15]
Huang, S. T., Good, M., & Zauszniewski, J. A. (2010). The Effectiveness of Music in Relieving Pain in Cancer Patients: A Randomized Controlled Trial. International Journal of Nursing Studies, 47, 1354-1362. https://doi.org/10.1016/j.ijnurstu.2010.03.008
[16]
International Association for the Study of Pain (IASP) (2011). Classification of Chronic Pain (2nd ed.). https://www.iasp-pain.org/PublicationsNews/Content.aspx?ItemNumber=1673
[17]
Jeffrey, L. G. M., Seok, H. K., Alexis, J. K., Michael, H. J., & Albert, R. (2006). Effectiveness of Virtual Reality for Pediatric Pain Distraction during IV Placement. Cyberpsychology & Behavior, 9, 207-212. https://doi.org/10.1089/cpb.2006.9.207
[18]
Jill, E. M., & Lindsey, L. C. (2007). Interventions for Paediatric Procedure-Related Pain in Primary Care. Paediatric Child Health, 12, 111-116.
[19]
Katja, W., Markus, P., & Irene, T. (2008). Neurocognitive Aspects of Pain Perception. Trends in Cognitive Sciences, 12, 306-313. https://doi.org/10.1016/j.tics.2008.05.005
[20]
Katja, W., Markus, P., & Irene, T. (2008). Neurocognitive Aspects of Pain Perception. Sciencedirect, 12, 306-313. https://doi.org/10.1016/j.tics.2008.05.005
[21]
Kelly, J. C., Groarke, P. J., Butler, J. S., Poynton, A. R., & O’Bryan, J. M. (2012). The Natural History and Clinical Syndromes of Degenerative Cervical Spondylosis. Advances in Orthopedics, 2012, Article ID: 393642. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227226 https://doi.org/10.1155/2012/393642
[22]
Kuo, D. T., & Tadi, P. (2020). Cervical Spondylosis. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551557
[23]
Mark, I. J., Raga, A. E., & Osama, A. T. (2013). The Prevalence of Chronic Pain in Developing Countries. Future Medicine, 3, 83-86. https://doi.org/10.2217/pmt.12.83
[24]
McCormack, B. M., & Weinstein, P. R. (1996). Cervical Spondylosis. An Update. Western Journal of Medicine, 165, 43-51.
[25]
Merskey, H., & Bogduk, N. (1994). Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms (2nd ed., p. 210). Seattle, WA: IASP Press.
[26]
Nabarum, D., Leo, B. J. D., & Daniel, C. (2018). Opioid Crisis: No Easy Fix to Its Social and Economic Determinants. American Journal of Public Health, 108, 182-186. https://doi.org/10.2105/AJPH.2017.304187
[27]
Nora, D. V., & Thomas, A. M. (2016). Opioid Abuse in Chronic Pain—Misconceptions and Mitigation Strategies 2016. The New England Journal of Medicine, 374, 1253-1263. https://doi.org/10.1056/NEJMra1507771
[28]
Pestana, S. A., Silva, J. R., & Amilcar, J. T. (2015). Cognitive and Emotional Modulation of Pain. European Psychiatry, 30, 1514. https://doi.org/10.1016/S0924-9338(15)31169-X
Priyadharshini, K., & Shoba, N. (2016). Effect of Music Therapy on Pain and Anxiety Levels of Cancer Patients: A Pilot Study. Indian Journal of Palliative Care, 22, 307-311. https://doi.org/10.4103/0973-1075.185042
[31]
Rahim, K. A., & Stambough, J. L. (1992). Radiographic Evaluation of the Degenerative Cervical Spine. Orthopedic Clinics of North America, 23, 395-403.
[32]
Richard, I. N., Joel, L. S., Leonard, P. Y., & Bonnie, G. (2003). Multidisciplinary Treatment of Chronic Pain: Long-Term Follow-Up of Low-Back Pain Patients. Pain, 4, 283-292.
[33]
Singh, S., Kumar, D., & Kumar, S. (2014). Risk Factors in Cervical Spondylosis. Journal of Clinical Orthopaedics and Trauma, 5, 221-226. https://doi.org/10.1016/j.jcot.2014.07.007
[34]
Stoffman, M. R., Robert, M. S., & King, J. T. (2005). Cervical Spondylosis and Myelopathy, Depression, and Anxiety: A Cohort Analysis of 89 Patients. Neurosurgery, 57, 307-313. https://doi.org/10.1227/01.NEU.0000166664.19662.43
[35]
Sturgeon, J. A., & Zautra, A. (2010). Resilience: A New Paradigm for Adaptation to Chronic Pain. Current Pain and Headaches Reports, 14, 105-112. https://doi.org/10.1007/s11916-010-0095-9
[36]
Supriya, S., Sanjenbam, E. C., & Atul, C. (2017). Effectiveness of Diversional Activity on Pain and Anxiety during Venipuncture among Children in a Selected Hospital Dehradun, Uttarakhand. Pediatric & Therapeutics, 7, Article ID: 1000334.
[37]
Suzanne, C. S., Brenda, G. B., Janice, L. H., & Kerry, H. C. (2010). Brunner & Suddarth’s Textbook of Medical and Surgical Nursing (12th ed., pp. 251-256). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
[38]
Turk, D. C., & Rudy, T. E. (1987). IASP Taxonomy of Chronic Pain Syndromes: Preliminary Assessment of Reliability. Pain, 30, 177-189. https://doi.org/10.1016/0304-3959(87)91073-6
[39]
Vicki, R. H., & Amanda, C. W. (1998). Activities Training: Integrating Behavioral and Cognitive Methods with Physiotherapy in Pain Management. Journal of Occupational Rehabilitation, 8, 47-60. https://doi.org/10.1023/A:1023056515292
