Physiotherapy for patients with chronic pain: An operant-behavioural approach

The aim of this study was to demonstrate a physiotherapy application of operant-behavioural theoretical principles for patients with chronic pain. The goals of treatment from this theoretical orientation were to decrease pain behaviours and suffering and to improve function. The treatment programme incorporated members from a number of disciplines, including physicians, physiotherapists and psychologists, over the course of 3 weeks. Four female patients with intractable, heterogeneous chronic pain complaints comprised the sample. Each subject was studied in a single-case format, using a multiple-baseline design. Standardised measures of function, exercise tolerance and pain were collected the first, second and third week of treatment for each subject. The data were analysed graphically. Clinically significant reductions in degree of suffering were noted for three subjects; pain intensity either increased or remained constant for all subjects. There were improvements in several of the function and exercise tolerance measures for three subjects between the first and third week measurements. The results of these case studies demonstrate the potential and efficacy of applying operant-behavioural principles to physiotherapy for reduction of suffering and improvement in physical functioning.