Preventing and modulating learned wound pain

Wounds cause pain but the consequences of wound pain remain largely unknown. Studies from other disciplines have shown that pain can contribute to the long-term physiological and emotional consequences of the pain experience, setting the stage for the phenomenon referred to as "learned pain." Providing ways to help patients avoid learning pain--ie, modulating pain anticipation/expectation, peripheral nerve blocks, pretreatment analgesics, biophysical technologies, modification of patient and provider behavior, judicious choice of dressings, and behavioral therapies--has been found to play a significant role in decreased physical and emotional discomfort and improved outcomes. Existing evidence on pain suggests that wound pain most likely consists of a combination of local, systemic, and learned phenomena retained by the patient as long-term "pain memories" as well as acute reaction to stimuli. Until the consequences of wound pain are fully appreciated, healthcare providers should consider application of research findings from other disciplines to reduce pain and prevent the learning and development of pain memories.