Pain processing is complex, with many factors, just like its consequences and treatment targets. Treatment targets include three broad domains: physical, psychological, and social.
Each patient has a unique set of pain contributors and manifestations that make up their unique pain signature. The physical pain generator, such as arthritis initiates the sensation of pain, also known as nociception.
Psychological treatment targets include fear avoidance beliefs that manifest in fear of self-injury related to activity, depression, and low self-efficacy.
Low self-efficacy involves a lack of belief in getting better, and poor coping skills. Catastrophizing is a specific kind of maladaptive pain coping style, characterized by the tendency to magnify the threat value of pain, and to feel helpless in the context of pain. Patients who catastrophize can’t inhibit pain-related thoughts.