Similarities between explaining dizziness and explaining pain? Exploring common patient experiences, theoretical models, treatment approaches and potential therapeutic narratives for persistent dizziness or pain

ABSTRACT

Pain and dizziness are common experiences throughout the lifespan. However, nearly a quarter of those with acute pain or dizziness experience persistence, which is associated with disability, social isolation, psychological distress, decreased independence, and poorer quality of life. Thus, persistent pain or dizziness impacts peoples’ lives in similarly negative ways. Conceptual models of pain and dizziness also have many similarities. Many of these models are more expansive than explaining mere symptoms; rather they describe pain or dizziness as holistic experiences that are influenced by biopsychosocial and contextual factors. These experiences also appear to be associated with multi-modal bodily responses related to evaluation of safety, threat detection and anticipation, as influenced by expectations, and predictions anticipation, not simply a reflection of tissue injury or pathology. Conceptual models also characterize the body as adaptable and therefore capable of recovery. These concepts may provide useful therapeutic narratives to facilitate understanding, dethreaten the experience, and provide hope for patients. In addition, therapeutic alliance, promoting an active movement-based approach, building self-efficacy, and condition-specific approaches can help optimize outcomes. In conclusion, there are significant overlaps in the patient experience, theoretical models and potential therapeutic narratives that guide care for people suffering with persistent pain or dizziness.

KEYWORDS:

• Pain neuroscience education
• chronic pain
• persistent dizziness
• vestibular
• rehabilitation

Acknowledgments

The authors would like to thank Tim Cocks and Jon Stone for their conceptual assistance, insight, and suggestions.

Disclosure statement

BSB presents continuing education courses on behalf of the Neuro Orthopaedic Institute (NOI) Group for clinicians (mainly physical therapists). Some of these courses include discussions about Explaining Pain. He is paid as an independent contractor for his teaching. The authors have no other financial relationships with the NOI Group nor their products. MAB has no affiliation with the NOI Group. The authors declare that they have no other known conflicts of interest.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.