Association Between Pain Catastrophizing, Spouse Responses to Pain, and Blood Pressure in Chronic Pain Patients: A Pathway to Potential Comorbidity

2012 ◽  
Vol 20 (4) ◽  
pp. 590-598 ◽  
Author(s):  
Michelle T. Leonard ◽  
David K. Chatkoff ◽  
Meghan Gallaway
Keyword(s):  
Blood Pressure ◽  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Chronic Pain Patients ◽  
Spouse Responses ◽  
Pain Patients

Evaluation of Using the Sphygmomanometer Test to Assess Pain Sensitivity in Chronic Pain Patients vs Normal Controls

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2903-2912
Author(s):  
Seth Butler ◽  
Kyle Draleau ◽  
Ross Heinrich ◽  
Liem Nguyen ◽  
David Shbeeb ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Sensitivity ◽  
Pain Catastrophizing ◽  
Sensitivity Test ◽  
Heat Sensitivity ◽  
Nociceptive Response ◽  
Sensitivity Tests ◽  
Pressure Algometer ◽  
Chronic Pain Patients ◽  
Pain Patients

Abstract Objectives Objectively measuring pain sensitivity has not been easy in primary care clinics. A sphygmomanometer test (a sensory test that measures an individual’s nociceptive response to pressure using a standard blood pressure cuff) has recently been established to test pain sensitivity. Here, we examined the feasibility of using the sphygmomanometer test with chronic pain patients. Design Population, observational study. Settings A community hospital multidisciplinary Pain Center and a private nonprofit university. Subjects Healthy controls and chronic pain patients were recruited. Methods All subjects underwent four pain sensitivity tests: a pressure algometer test, a cold pressure test, a heat sensitivity test, and a sphygmomanometer test. Participants then completed four established surveys for evaluating depression (Patient Health Questionnaire–9), anxiety (General Anxiety Disorder–7), fatigue (Fatigue Severity Scale), and pain catastrophizing (Pain Catastrophizing Scale). Results Although pain patients had significantly higher levels of depression, anxiety, fatigue, and pain catastrophizing, as well as reported pain scores, no significant differences in pain sensitivity were detected via any of the pain sensitivity tests. In the control but not the patient group, results from all pain sensitivity tests including the sphygmomanometer test were significantly correlated with each other. Unlike other pain sensitivity tests, the sphygmomanometer test did not correlate with measures of depression, anxiety, fatigue, or pain catastrophizing characteristics. Conclusions Our results indicate the unique characteristics of the sphygmomanometer test as a pain sensitivity test, particularly when utilized for individuals with chronic pain. Multiple pain sensitivity tests that assess various sensory modalities are needed to evaluate pain sensitivities in chronic pain patients.

scholarly journals Distraction Analgesia in Chronic Pain Patients

2014 ◽  
Vol 121 (6) ◽  
pp. 1292-1301 ◽  
Author(s):  
Kristin L. Schreiber ◽  
Claudia Campbell ◽  
Marc O. Martel ◽  
Seth Greenbaum ◽  
Ajay D. Wasan ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Temporal Summation ◽  
Pain Catastrophizing ◽  
Pain Modulation ◽  
Analysis Of Covariance ◽  
Noxious Stimulation ◽  
Conditioned Pain Modulation ◽  
Opioid Use ◽  
Chronic Pain Patients ◽  
Pain Patients

Abstract Background: Diverting attention away from noxious stimulation (i.e., distraction) is a common pain-coping strategy. Its effects are variable across individuals, however, and the authors hypothesized that chronic pain patients who reported higher levels of pain catastrophizing would derive less pain-reducing benefit from distraction. Methods: Chronic pain patients (n = 149) underwent psychometric and quantitative sensory testing, including assessment of the temporal summation of pain in the presence and absence of a distracting motor task. Results: A simple distraction task decreased temporal summation of pain overall, but, surprisingly, a greater distraction analgesia was observed in high catastrophizers. This enhanced distraction analgesia in high catastrophizers was not altered when controlling for current pain scores, depression, anxiety, or opioid use (analysis of covariance [ANCOVA]: F = 8.7, P < 0.005). Interestingly, the magnitude of distraction analgesia was inversely correlated with conditioned pain modulation (Pearson R = −0.23, P = 0.005). Conclusion: Distraction produced greater analgesia among chronic pain patients with higher catastrophizing, suggesting that catastrophizing’s pain-amplifying effects may be due in part to greater attention to pain, and these patients may benefit from distraction-based pain management approaches. Furthermore, these data suggest that distraction analgesia and conditioned pain modulation may involve separate underlying mechanisms.

scholarly journals Chronic Pain Patients’ Gaze Patterns toward Pain-Related Information: Comparison between Pictorial and Linguistic Stimuli

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 530 ◽  
Author(s):  
Lee ◽  
Beom ◽  
Choi ◽  
Lee ◽  
Lee
Keyword(s):  
Chronic Pain ◽  
Eye Tracking ◽  
Attentional Bias ◽  
Pain Catastrophizing ◽  
Pain Clinic ◽  
Related Information ◽  
Chronic Pain Patients ◽  
Attentional Engagement ◽  
Pain Patients

Background and Objectives: The attentional bias and information processing model explained that individuals who interpret pain stimuli as threatening may increase their attention toward pain-related information. Previous eye tracking studies found pain attentional bias among individuals with chronic pain; however, those studies investigated this phenomenon by using only one stimulus modality. Therefore, the present study investigated attentional engagement to pain-related information and the role of pain catastrophizing on pain attentional engagement to pain-related stimuli among chronic pain patients by utilizing both linguistic and visual stimulus. Materials and Methods: Forty chronic pain patients were recruited from the rehabilitation center, the back pain clinic, and the rheumatology department of Chung-Ang University Hospital in Seoul, Korea. Patients observed pictures of faces and words displaying pain, presented simultaneously with neutral expressions, while their eye movements were measured using the eye tracking system. A t-test and ANOVA were conducted to compare stimulus pairs for the total gaze duration. Results revealed that chronic pain patients demonstrated attentional preference toward pain words but not for pain faces. An ANOVA with bias scores was conducted to investigate the role of pain catastrophizing on attentional patterns. Results indicated that chronic pain patients with high pain catastrophizing scores gazed significantly longer at pain- and anger-related words than neutral words compared to those with low pain catastrophizing scores. The same patterns were not observed for the facial expression stimulus pairs. Conclusions: The results of the present study revealed attentional preference toward pain-related words and the significant role of pain catastrophizing on pain attentional engagement to pain-related words. However, different patterns were observed between linguistic and visual stimuli. Clinical implications related to use in pain treatment and future research suggestions are discussed.

scholarly journals Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Binbin Wu ◽  
Xinyi Tian ◽  
Ce Shi ◽  
Chenchen Jiang ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Spinal Stenosis ◽  
Pain Catastrophizing ◽  
Lumbar Discectomy ◽  
Healthy Controls ◽  
Healthy Individuals ◽  
Chronic Pain Patients ◽  
Endoscopic Lumbar Discectomy ◽  
Lumbar Spinal ◽  
Pain Patients

Introduction. “U” route transforaminal percutaneous endoscopic lumbar discectomy (PELD) was introduced for lumbar spinal stenosis (LSS) combined with disc herniation (DH) treatment. This study aims to explore the efficacy and safety of “U” route PELD on chronic pain patients with LSS combined with DH. Methods. Degenerative LSS combined with DH patients who underwent “U” route PELD were reexamined, and 80 patients were recruited and followed up for 2 years. The other 80 healthy individuals who were age- and sex-matched to the patients without chronic pain were enrolled as healthy controls. Minimum dura sac cross-sectional area (mDCSA) by MRI, Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab outcomes were assessed. Emotional evaluation of pain catastrophizing and depression was documented with Pain Catastrophizing Scale (PCS) and Beck Depression Inventory (BDI), respectively, for patients before and after surgery and healthy individuals. Results . All patients were of the age range from 47 to 85 years, with an average of 59.5 ± 9.76 years. Symptoms duration was 114.6 ± 22.77 months, operation time was 87.7 ± 25.20 minutes, and the average hospital stay was 5.8 ± 2.81 days. Four patients quit, and hence, a total of 76 patients completed the follow-up. The results indicated that mDCSA was improved significantly after operation ( p < 0.001 ), either low back and leg VAS or ODI decreased over time ( p < 0.001 ), and the excellent-to-good rate was improved from 88.75% to 93.42% during postoperative 2 years ( p < 0.05 ). Complications of dural tear, nerve root, or dysesthesia were reported in 5 patients, and all recovered after conservative therapy. The scores of pain catastrophizing were reduced after operation ( p < 0.001 ), but no significance of BDI was found between patients and healthy controls ( p > 0.05 ). Conclusions. The “U” route PELD seems an alternative to LSS combined with DH treatment, which might reach a better decompression and effectively improve chronic pain conditions. Still, the complications were potential and required further consideration.

Does validation and alliance during the multimodal investigation affect patients’ acceptance of chronic pain? An experimental single case study

2019 ◽  
Vol 19 (1) ◽  
pp. 73-82 ◽  
Author(s):  
Mikael Svanberg ◽  
Ann-Christin Johansson ◽  
Katja Boersma
Keyword(s):  
Chronic Pain ◽  
Therapeutic Effect ◽  
Pain Catastrophizing ◽  
Single Case ◽  
Rehabilitation Program ◽  
Self Report ◽  
Pain Coping ◽  
Chronic Pain Patients ◽  
Before And After ◽  
Pain Patients

Abstract Background and aims Among chronic pain patients who are referred to participation in a multimodal rehabilitation program (MMRP), pain catastrophizing and dysfunctional pain coping is common. In many cases it may have driven the patient to a range of unsuccessful searches for biomedical explanations and pain relief. Often these efforts have left patients feeling disappointed, hopeless and misunderstood. The MMRP process can be preceded by a multimodal investigation (MMI) where an important effort is to validate the patient to create a good alliance and begin a process of change towards acceptance of the pain. However, whether the MMI has such therapeutic effect is unclear. Using a repeated single case experimental design, the purpose of this study was to investigate the therapeutic effect of MMI by studying changes in patients’ experience of validation, alliance, acceptance of pain, coping, catastrophizing, and depression before and during the MMI process. Methods Participants were six chronic pain patients with high levels of pain catastrophizing (>25 on the Pain Catastrophizing Scale) and risk for long term disability (>105 on the Örebro Musculoskeletal Pain Screening Questionnaire) who were subjected to MMI before planned MMRP. For each patient, weekly self-report measures of validation, alliance and acceptance of pain were obtained during a 5–10-weeks baseline, before the MMI started. Subsequently, these measures were also obtained during a 6–8 weeks MMI process in order to enable comparative analyses. Additionally, pain coping, depression and pain catastrophizing were measured using standardized questionnaires before and after the MMI. Results Irrespective of experiences of validation and alliance before MMI, all six patients felt validated and experienced a good alliance during MMI. Acceptance of pain improved only in one patient during MMI. None of the patients showed clinically relevant improvement in pain coping, depression or catastrophizing after the MMI. Conclusions The patients did not change their acceptance and pain coping strategies despite of good alliance and experience of validation during the MMI process. Even if the design of this study precludes generalization to chronic pain patients in general, the results suggest that MMI may not have a therapeutic effect.

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