L'apport des attentes du patient à la gestion de la douleur chronique

Pain is a complex phenomenon that cannot be reduced solely to its physical component. It is an experiential condition that comprise a sensory and an affective dimension. Despite being universal, pain is a fundamentally personal and subjective experience. Although various pain management interventions are now available, research indicate that their efficacy is generally limited. In order to improve existing interventions, studies on the placebo effect suggest that the contribution of various non-specific factors, also called common factors in psychology, deserves serious consideration. Among these factors, the most recent scientific literature highlights the importance of considering the expectations of patients who undertake pain-relieving treatments. Indeed, a growing number of studies show the beneficial effects, both physiologically and therapeutically, of positive expectations in the context of pain management. In fact, it is reasonable to believe that considering expectations, along with empirically validated treatments, could optimize interventions aimed at chronic pain management. Therefore, it is now advisable that clinicians review their own practice in order to give prominence to strategies aimed at assessing and enhancing patients' expectations. Accordingly, this article provides an overview of current knowledge on the contribution of expectations to the regulation of chronic pain and puts forward practical strategies and actions to enhance both expectations and their beneficial effects.