Pain Unstuck: The Role of Action and Motivation

Background: What is it that motivates our actions? As human
beings, existing as part of complex societies, the actions we take are
subject to multiple, often competing motives. Spanning nonconscious reflexes, cognitively derived choice as well as long- and
short-term goals, our actions allow us to make sense of our environment. Pain disrupts action and hijacks our intentions. Whilst
considered adaptive when temporary, pain that persists continues
to interrupt and can threaten our ability to actively investigate a
changing world.
Objective: This work is a narrative review.
Results: Drawing upon three complementary theoretical approaches
to pain: an embodied framework, a motivational approach and the
avoidance-endurance model, this review places the relationship
between pain, motivation and action at its core, unpicking a
dynamic process that can become stuck.
Conclusions: In taking a wide view of pain and action, we expose the
nuances within drive to goal behaviour in the presence of pain. This
has implications for the clinic, specifically in relation to assessing the
multifactorial influences that shape action in pain. But it also seeks
to go further, considering the broader environment in which we
make decisions and the influence that other professionals, outside of
typical healthcare roles, may play a part in the maintenance and
resolution of pain.
Key Words: pain unstuck, embodied pain, motivation, cognitive
bias, avoidance vs. endurance