The healing others: the essential role of social support on chronic pain management

TO THE EDITOR

I came across an interesting article published in the Korean Journal of Pain regarding the different strategies used for pain management. Dr. Jo emphasized that from pharmaceuticals to interventional procedures, each modality offers a unique avenue toward pain relief, yet none are immune to limitations [1]. This insight enabled me to reflect on how we, as human beings, will do our best and exert effort to alleviate the suffering of our sick loved ones, specifically in dealing with chronic pain. As much as possible, we do not want them to feel more pain through the adverse effects of pharmacological treatment or undergo further surgeries. As they feel the intense pain caused by their illness, we want to let them feel our support and the presence of their own family and friends, which can help them realize that we journey with them in these trying times and be more optimistic toward recovery. Thus, I aim to elaborate on how social support can significantly complement any pharmacological and surgical interventions for chronic pain management.

Pain is an unpleasant sensory and emotional experience. When it continues for longer than three months, it results in chronic pain [2]. Over the years, experts have focused on several frameworks to understand chronic pain's nature comprehensively. It is important to note that chronic pain does not only involve the biological/physical aspect of the patient but must be understood from a multidimensional perspective. This is what the biopsychosocial model is all about. It describes pain as a dynamic interaction among physiological, psychological, and social factors that reciprocally influence one another [3]. This means that these factors contribute to the patient’s experience of pain. The physiological/biological factors are those associated with brain function and genetics, including the type of injury to the body and the different problems of the organs. The psychological factors are the ones linked to emotions, such as fear and avoidance, mood, and mental perspectives, while the social factors are associated with the support/non-support and care that is provided by those people connected to the patient [2]. As these factors affect one another, it is therefore appropriate that the treatment is multidimensional so that all the factors are covered to obtain a favorable result.

Social support is the provision of assistance or comfort to others, typically to help them cope with biological, psychological, and social stressors. It may arise from any interpersonal relationship between the individual and their social network, such as family members, friends, neighbors, religious institutions, colleagues, caregivers, or support groups [4]. It is a non-pharmacological intervention that can be enjoined with pre- and post-pharmacological and surgical treatment. Many studies have proven social support's essential role in battling different diseases. In a systematic review of 38 published articles in PubMed and PsycINFO regarding the link between social support and chronic pain experience, findings revealed that social support decreases the adverse influence of pain-related stress, reappraises pain-related stress, and facilitates coping attempts. Also, social support was associated with reduced neural and physiological stress systems in response to pain [5]. During the COVID-19 pandemic, another study highlighted that social support plays a "therapeutic" role in the healing and recovery of famous celebrities/patients who suffered severely from the virus. Their respective families, friends, and support groups (even online) helped boost their morale and lifted their spirits to be more courageous in facing the dreaded disease [6]. Social support, utilized in group-based interventions, can also create a sense of community and belonging among patients by providing a supportive environment where they can share their challenges and successes. These interventions can help individuals feel as though they are better able to manage their chronic pain while providing them with the tools to evaluate and cope with stressors more effectively and, thus, engage in more adaptive behaviors [7]. Lastly, another study stressed that greater social support was associated with less psychological distress that patients in chronic pain typically experience. It suggests an important link between social support and mindfulness and that their integration in the pursuit of mental health should be considered in future behavioral interventions [8].

The sample studies mentioned in References 5–8 are presented to validate the claim concerning the essentiality of social support in chronic pain management. While pharmacological and surgical treatments are responsible for the physiological aspect of chronic diseases, the psychosocial factors, on the other hand, are addressed by social support. With this, governments and their respective health agencies must integrate creatively into their policies and programs to promote and enhance different avenues for social support, focusing on how every family and various support groups/organizations can better serve patients with chronic pain. There is still much to gain for every pain if everyone's support is not in vain.