[114] Addressing these factors is essential for appropriate management of the orofacial pain, as treatment outcome has been shown to be related to psychological comorbidity.[49] Affective as well as interpretative and cognitive factors play an important role in the patient’s perception of pain. One small qualitative study found that their patients perceived their orofacial pain to “have no limits and to repressively permeate all aspects of their existence:

social, practical, and emotional.”[105] This illustrates the LY2109761 cell line significant impact that orofacial pain can have on quality of life, and provides a focal point for assessment of pain management outcomes. Patients need to know that although the sensation of pain may not be completely alleviated by treatment, the impact of pain upon their Small molecule library daily life can certainly be modulated. Chronic pain management should be holistic in nature and approach, and involves addressing all the factors that modulate the pain experience.[7] Addressing unrealistic patient expectations is important for setting achievable treatment goals. There remains a common perception that pain should always be curable, as demonstrated in this

quote from a patient: “Many don’t understand the pain I feel. They think I should be over this pain by now. Others feel I should seek other doctors. They feel there should be something to relieve this terrible pain and ask me why I’m not trying to find it, if it is so bad. Pain as defined by International Association for the Study of Pain is both a “sensory and emotional experience,” and it should be managed as such. A recent study has shown that chronic musculoskeletal pain can be experienced

as a “constant adversarial struggle,” and the researchers suggest that patient and clinician expectations of a diagnosis unless and cure need to be challenged.[115] Beliefs, coping strategies, and catastrophizing predict functioning in patients with chronic pain, and this should be considered when individualizing pain management programs.[116] This extends to patients’ beliefs about medication as these will influence adherence.[117] Successful pain management is also related to the patient’s self-efficacy beliefs and ability to learn and use positive coping strategies.[118] Recognition of the contribution of social, psychological, and lifestyle factors to the pain experience, as expressed in the patient quote earlier, is essential for taking the next steps in chronic pain management and achieving a reduction in the impact of pain on quality of life. The provision of support for these next steps is a fundamental part of multidisciplinary pain management. Pain management programs delivered in group settings normalizes the pain experience, and the concept of an improved pain experience because of observation of others with a similar complaint is also expressed by the patient quoted earlier.