PainSA is a chapter of the International Association for the Study of Pain. Our mission is to improve all aspects of pain management in Southern Africa.

Exploring The Potential Role Of Mesocorticolimbic Circuitry In Motivation For And Adherence To Chronic Pain Self-management Interventions

Adherence to pain self-management strategies plays a crucial role in improving psychobehavioral outcomes for individuals with chronic pain. However, achieving substantive adherence to these treatments, which teach adaptive skills, is often challenging, leading to negative consequences for both individuals and society. Motivation for behavior change is identified as a key predictor of treatment adherence, yet despite efforts to target motivation through behavioral techniques, nonadherence remains a significant barrier to positive clinical outcomes. This review aims to explore the role of the mesocorticolimbic system, associated with reward processing and motivation in the brain, in influencing treatment motivation among chronic pain patients and its impact on adherence. It examines evidence supporting motivation as a crucial determinant of adherence, presents neuroimaging findings linking mesocorticolimbic circuitry and motivation, and discusses evidence of dysfunction in this system among chronic pain patients. The review proposes a neurobehavioral model for adherence to pain self-management interventions, outlining testable hypotheses, and discusses potential research and intervention implications arising from this model.