The multidisciplinary team in the management of chronic pain and pain-related fear: an evidence-based approach in a clinical case

• Published in: Physiotherapy theory and practice Vol. 41; no. 2; pp. 447 - 464
• Main Authors: Venturin, Davide, Battimelli, Andrea, di Cara, Giovanni, Poser, Antonio
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Ltd 01.02.2025
• Subjects: Acceptance and commitment therapy; Arthralgia - diagnosis; Arthralgia - physiopathology; Arthralgia - psychology; Arthralgia - therapy; Avoidance behavior; Biomechanics; Case reports; Chronic pain; Chronic Pain - diagnosis; Chronic Pain - physiopathology; Chronic Pain - psychology; Chronic Pain - rehabilitation; Chronic Pain - therapy; Clinical assessment; Discrimination training; Emotional well being; Fear; Fear & phobias; Female; Humans; Imagery; Interdisciplinary aspects; Knee Joint - physiopathology; Knee Joint - surgery; Medical history; Mindfulness; Multidisciplinary teams; Multimodality; Pain Management - methods; Pain Measurement; Patient Care Team; Physical Therapy Modalities; Physiotherapy; Problem solving; Psychological aspects; Psychological well being; Rehabilitation; Social factors; Surgery; Treatment Outcome; Usefulness; Young Adult; chronic pain; pain-related fear; Multidisciplinary team; neurocognitive rehabilitation; psychology; anterior knee pain
• ISSN: 0959-3985; 1532-5040; 1532-5040
• DOI: 10.1080/09593985.2024.2336099

Pain is a complex, intimate, and subjective experience influenced by biological, psychological, and social factors. This case report investigates the effectiveness of a multidisciplinary team approach in addressing chronic pain and pain-related fear. The case report describes a 22-year-old female who experienced anterior knee pain for seven years, despite undergoing two knee surgeries and physiotherapy without improvement. Following a comprehensive assessment, which included a detailed medical history, clinical examination, and thoughtful clinical analysis, a multidisciplinary approach was recommended. Employing an evidence-based methodology that integrated neurocognitive rehabilitation techniques, including Pain Neuroscience Education, Graded Motor Imagery, and Tactile Discrimination Training, alongside psychological rehabilitation strategies such as Mindfulness, Acceptance and Commitment Therapy, and Problem-Solving Therapy, the report presents a comprehensive in-depth rehabilitation plan exemplifying the application of this multimodal approach within a clinical setting in a patient with chronic pain. This approach is designed not to address the biomechanical aspects but to delve into the cognitive facets associated with pain perception and avoidance, as well as potential psychological factors that may be influencing the onset and persistence of symptoms. The scores from the rating scales provided valuable insights into patient progress in pain management, functional improvement, fear of movement, and overall physical, psychological, and emotional well-being, at six months. This case report offers valuable insights into the usefulness of this multidisciplinary and multimodal approach, highlighting its potential as an avenue in the management of chronic pain and pain-related fear.