Tag Archives: catastrophizing

Catastrophizing NOT predictive of poor outcomes

Pain coping skills training doesn’t improve knee arthroplasty outcomes– by Bruce Jancin – June 2019

Here’s the research I’ve been waiting for to disprove the hype around the idea that “catastrophizing leads to more pain and worse outcomes”. In this study, they expected to get results confirming this “catastrophizing hypothesis“, but they found no such thing.

They did find that when patients’ pain was relieved after successful knee replacement (80% success rate), their catastrophizing score was also dramatically reduced, regardless of which trial arm they were in.

This is contradictory to many less rigorous studies that showed catastrophizing leading to worse outcomes. But this prospective randomized study shows what pain patients have always known:

When pain is relieved, so is catastrophizing.  Continue reading

Pain Minimized or Dismissed as Catastrophizing

Our Pain is being Minimized or Dismissed as Catastrophizing

When does normal concern about relentless pain become excessive and catastrophizing?

Who has the power to make this decision?

I’m exasperated and offended by the recent over-promotion and over-simplification of the latest popular theory about chronic pain, which uses the derogatory term “catastrophizing” to describe our well-founded concerns about our pain.   Continue reading

Pain Catastrophizing: What Clinicians Need to Know

Pain Catastrophizing: What Clinicians Need to Know – Apr 2017 – By Robert J. Gatchel, PhD, ABPP and Randy Neblett, MA, LPC, BCB

during the past 2 decades, chronic pain clinical researchers began to emphasize the important role that certain specific sets of negative beliefs (such as catastrophizing and fear avoidance) play in the maintenance and exacerbation of chronic pain

Gatchel et al define pain catastrophizing as

“an exaggerated negative orientation toward actual or anticipated pain experiences…current conceptualizations most often describe it in terms of appraisal or as a set of maladaptive beliefs.”   Continue reading

Nora Volkow on Rx opioids, chronic pain and ‘hype’

Nora Volkow on prescription opioids, chronic pain and ‘hype’ – Opioid Watch – Nonprofit News from The Opioid Research Institute – July 2018

Research psychiatrist Nora Volkow, MD—the director of the National Institute on Drug Abuse for the past 15 years—is one of the world’s foremost authorities on addiction. Her pioneering work with brain imaging has changed society’s understanding of the phenomenon.

By showing how addictive drugs alter the brain’s chemistry, she helped prove that addiction was a chronic disease rather than a moral failing.

What follows is part 1 of a two-part interview, which was conducted by email. All links in her answers are to supporting references Volkow provided.   Continue reading

Absolutes in Chronic Pain Treatment Can Backfire

Absolutes in Chronic Pain Treatment Can Backfire – National Pain Report – Oct 2017 by Ed Coghlan

Beth Darnall PhD is a pain psychologist, noted researcher and Clinical Professor at the Stanford University as well as successful author on chronic pain.

She and her research team have just landed a major grant to study chronic pain. We interviewed her on the grant, the opioid controversy and the National Pain Strategy

Beth Darnall is the main proponent of the “catastrophizing” theory about chronic pain, which is that the patient’s fears of pain supposedly cause most of chronic pain’s amplification.   Continue reading

Preoperative Catastrophizing != Postoperative Pain

Preoperative pain catastrophizing and postoperative pain after total knee arthroplasty: a prospective cohort study with one year follow-up – free full-text /PMC4869354/ – BMC Musculoskelet Disord. – May 2016

Conclusions: No associations were found between preoperative pain catastrophizing and pain eight weeks or one year after surgery.

The decrease in PCS-scores challenges evidence regarding the stability of pain catastrophizing. However, larger studies of psychological risk factors for pain after TKA are warranted.

This paper shows us that “catastrophizing” is actually distress from the severity of pain.  Continue reading

Catastrophizing Not a Factor in Spinal Nociceptive Processing

Pain Catastrophizing is Not Associated With Spinal Nociceptive Processing in People With Chronic Widespread Pain – The Clinical Journal of Pain – September 2017

“…we could find no evidence of a significant relationship between pain catastrophizing and measures of spinal nociceptive processing”

This seems significant in light of the push to blame so much of our chronic pain on catastrophizing. At least this proves that our pain doesn’t originate from catastrophizing.

Pain catastrophizing has been associated with

Continue reading

Temporal Summation (Additive Properties) of Pain

Temporal Summation of Pain” is just a fancy and scientifically specific way of saying that repeated pain is additive: after we’ve been whacked once, another hit in the same spot hurts more; If we get hit there over and over, we start cringing because it hurts more and more.

Evoked Temporal Summation in Cats to Highlight Central Sensitization Related to Osteoarthritis-Associated Chronic Pain: A Preliminary Study – Free full-text PMC4032234 – PLoS One. 2014 May

In cats, osteoarthritis causes significant chronic pain.

Chronicity of pain is associated with changes in the central nervous system related to central sensitization, which have to be quantified.  Continue reading

“Catastrophizing” – Thomas Dikel

“Catastrophizing” – Thomas Dikel – Medium – Aug 2017

Mr. Dikel seems to have the same feelings about catastrophizing that I do:

I REALLY am starting to resent, not quite hate, but getting close, the use of the word “Catastrophizing.”

What it’s supposed to mean is a distortion in thinking in which something that isn’t that big a deal is made out to be a bloody CATASTROPHE! Its been described as always presuming the worst, making things worse than they are.   Continue reading

Blaming a patients’ doubts about “getting better”

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