How doubts about getting better influence chronic pain treatment success | Scienmag: Latest Science and Health News – May 2017
A leading psychology professor at The University of Texas at Arlington has focused international attention on how a chronic pain patient’s irrational doubts about never getting better can influence both his reactions to pain and even treatment outcomes.
Irrational? When your pain comes from a genetic flaw, it cannot “get better”.
This dismissiveness is typical of doctors who assume your complaints are just normal aches and pains or from a temporary injury. Continue reading
Pain Catastrophizing: An Updated Review | Indian J Psychol Med. 2012 | free full-text PMC article
Pain catastrophizing has been described for more than half a century which adversely affects the pain coping behavior and overall prognosis in susceptible individuals when challenged by painful conditions.
This is the first time I’ve heard that catastrophizing only affects “susceptible individuals”. It makes me wonder what they mean by “susceptible”.
It seems that any patient who needs opioids is assumed to be catastrophizing – otherwise, their pain wouldn’t be “that bad”. Continue reading
We are told that we shouldn’t “catastrophize” our pain because that makes it much worse, and that we need cognitive therapy to disabuse us of our catastrophic notions.
However, the definition of “catastrophe” is an event resulting in great loss and misfortune, and this is the undeniable truth of chronic pain, and no amount of “magical thinking” can change that.
I believe it’s much better to practice acceptance that this catastrophe of chronic pain happened.
It would be a waste of energy to pretend chronic pain is not a catastrophe, to pretend everything is “OK”, that you’re not expending so much effort, expense, and pain to manage it, pretend it isn’t always a challenge get through the day without collapsing from pain and fatigue. Continue reading
Actually, Let’s Not Be in the Moment – The New York Times – By Ruth Whippman – Nov. 26, 2016
The simplification and mass-production of a philosophy make it ridiculous.
I’m making a failed attempt at “mindful dishwashing,” the subject of a how-to article an acquaintance recently shared on Facebook.
According to the practice’s thought leaders, in order to maximize our happiness, we should refuse to succumb to domestic autopilot and instead be fully “in” the present moment, engaging completely with every clump of oatmeal and decomposing particle of scrambled egg.
Mindfulness is supposed to be a defense against the pressures of modern life, but it’s starting to feel suspiciously like it’s actually adding to them. Continue reading
Factors Associated with Higher Reported Pain Levels in Patients with Chronic Musculoskeletal Pain: A Cross-Sectional, Correlational Analysis – PLoS One. 2016
Chronic musculoskeletal pain is highly prevalent, disabling, and costly, and has many negative effects on quality of life.
The aim of this study was to investigate factors associated with higher reported pain levels in patients with chronic musculoskeletal pain among demographic, clinical, and psychological factors, and to evaluate whether insomnia is independently associated with pain intensity in this population.
A total of 357 patients with chronic musculoskeletal pain (pain duration ≥ six months) satisfied the study inclusion criteria and were included in the analyses Continue reading
Many pain patients are upset at being accused of catastrophizing. This theory claims that our concerns, worries, and fears about our pain are greatly increasing our pain, almost to the point of causing it.
The media picked up on the story and makes catastrophizing the actual cause of chronic pain, so this concept has been very damaging to pain patients seeking medical treatment for the physical causes of their pain.
My main point is this quote from a study:
“Catastrophizing is associated with the pain experience;
however, causation has not been established.”
Study Finds Strong Correlation Between Health Literacy and Pain Catastrophizing – Pain Medicine News – Aug 2016
Low health literacy was a significant predictor of pain catastrophizing and pain self-efficacy, according to a cross-sectional study of 300 indigent patients with chronic pain at five low-income clinics in rural Alabama
- experiencing want or need; impoverished,
- so poor as to lack even necessities; very needy
- lacking the necessities of life because of poverty; needy; poor;
This study was done on patients who are living extremely difficult lives with constant hardship and little medical care, so the results cannot be generalized to any other group. Continue reading
Fear-Avoidance Conditioning: Maintaining the Chronic Pain Cycle? – Pain – International Association for the Study of Pain | August 11, 2016
In an article recently published in Pain, researchers at the University of Leuven, Belgium propose a model for the transition from acute to chronic pain, based on fear-avoidance
With this model, which describes the distinct behaviors underlying perpetuation of or breaking from pain, researchers seek to guide pain-related research as well as pain management
In this model, conditioning plays a central role in the maintenance of pain, and authors argue that its disruption may lead to recovery. Continue reading
The causal status of pain catastrophizing: an experimental test with healthy participants. – PubMed – NCBI Eur J Pain. 2005 Jun
In the current study we report findings on the effects of experimentally induced catastrophizing about pain on expected pain, experienced pain and escape/avoidance behavior during a cold pressor task in a sample of healthy participants
It was hypothesized that increasing the level of catastrophizing would result in a higher level of expected pain, a higher level of experienced pain, and a shorter duration of ice-water immersion. Also, it was hypothesized that these relations might be stronger for participants who already catastrophized about pain prior to the experiment.
The results demonstrated that despite the successful attempt to induce catastrophizing, this neither significantly affected
- expected pain,
- experienced pain, and
- duration of ice-water immersion,
nor were these relations moderated by the pre-experimental level of catastrophizing.
Of course, because this study is from a decade ago, it will be disregarded.
Catastrophizing: Not a Ploy for Attention
Catastrophizing, defined as an exaggerated negative mental set, has consistently shown a negative impact on outcomes in patients with chronic pain and illness.
However, the factors that drive this cognitive distortion remain unclear.
Who gets to decide which “cognitions” are “distorted” when they are related to personal values?
In an effort to elucidate the underlying mechanisms, researchers led by Joan M. Romano, PhD, evaluated 2 models in the context of chronic fatigue, a chronic disabling condition often accompanied by pain. Continue reading