scholarly journals An investigation of perceptual biases in complex regional pain syndrome

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8819 ◽  
Author(s):  
Annick L. De Paepe ◽  
Valéry Legrain ◽  
Lien Van der Biest ◽  
Nadine Hollevoet ◽  
Alexander Van Tongel ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Complex Regional Pain Syndrome ◽  
Temporal Order Judgment ◽  
Pain Syndrome ◽  
The Body ◽  
Body Parts ◽  
Tactile Stimuli ◽  
Chronic Pain Patients ◽  
Pain State ◽  
Pain Patients

Patients with complex regional pain syndrome (CRPS) report cognitive difficulties, affecting the ability to represent, perceive and use their affected limb. Moseley, Gallace & Spence (2009) observed that CRPS patients tend to bias the perception of tactile stimulation away from the pathological limb. Interestingly, this bias was reversed when CRPS patients were asked to cross their arms, implying that this bias is embedded in a complex representation of the body that takes into account the position of body-parts. Other studies have failed to replicate this finding (Filbrich et al., 2017) or have even found a bias in the opposite direction (Sumitani et al., 2007). Moreover, perceptual biases in CRPS patients have not often been compared to these of other chronic pain patients. Chronic pain patients are often characterized by an excessive focus of attention for bodily sensations. We might therefore expect that non-CRPS pain patients would show a bias towards instead of away from their affected limb. The aim of this study was to replicate the study of Moseley, Gallace & Spence (2009) and to extend it by comparing perceptual biases in a CRPS group with two non-CRPS pain control groups (i.e., chronic unilateral wrist and shoulder pain patients). In a temporal order judgment (TOJ) task, participants reported which of two tactile stimuli, one applied to either hand at various intervals, was perceived as occurring first. TOJs were made, either with the arms in a normal (uncrossed) position, or with the arms crossed over the body midline. We found no consistent perceptual biases in either of the patient groups and in either of the conditions (crossed/uncrossed). Individual differences were large and might, at least partly, be explained by other variables, such as pain duration and temperature differences between the pathological and non-pathological hand. Additional studies need to take these variables into account by, for example, comparing biases in CRPS (and non-CRPS) patients in an acute versus a chronic pain state.

Literature Review

1999 ◽  
Vol 4 (4) ◽  
pp. 7-11
Keyword(s):  
Chronic Pain ◽  
Pain Syndrome ◽  
Persistent Pain ◽  
Maladaptive Behavior ◽  
Final Report ◽  
Chronic Pain Syndrome ◽  
Psychosocial Consequences ◽  
Chronic Pain Patients ◽  
Essential Questions ◽  
Pain Patients

Abstract Pain is the most common presenting complaint at an impairment evaluation. In the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), the term chronic pain is synonymous with chronic pain syndrome. The AMA Guides differentiates between pain of longstanding duration, termed persistent pain, and chronic pain syndrome, which is characterized as “the devastating and recalcitrant type [of pain] with major psychosocial consequences.” Persistent pain may exist in the absence of chronic pain syndrome, but chronic pain syndrome always presumes the presence of persistent pain, according to the AMA Guides. The assessment of chronic pain syndrome involves a multidimensional approach, and a physical examination alone may be misleading. Chronic pain syndrome is a biopsychosocial phenomenon of maladaptive behavior, and the AMA Guides describes diagnostic criteria for chronic pain syndrome. In addition, this article includes a checklist of characteristics shared by chronic pain patients, along with a list of essential questions that evaluators can ask in assessing pain and a list of pain, behavioral, and psychological inventories commonly used in independent medical evaluations. Physicians should choose a battery that is consistent with the needs of the assessment, and the final report should explain the findings and significance of the inventories used.

scholarly journals Talking about chronic pain: Misalignment in discussions of the body, mind and social aspects in pain clinic consultations

2021 ◽  
pp. 136345932110328
Author(s):  
Jana Declercq
Keyword(s):  
Chronic Pain ◽  
Gold Standard ◽  
Biopsychosocial Model ◽  
The Body ◽  
Pain Clinic ◽  
Social Aspects ◽  
The Social ◽  
Chronic Pain Patients ◽  
Bodily Experiences ◽  
Pain Patients

In Western societies, human existence and illness are mostly constructed from the perspective of mind-body dualism: body and mind are considered to function independently, and the body/the physical as primary and more real. Research shows, however, that mind-body dualism is no longer tenable, especially in healthcare contexts. This led to the rise the biopsychosocial model, in which bodily experiences, including illness, are seen an interplay of the physical and the psychological, and the social. This model is the current gold standard for treating chronic pain. As these perspectives on the body and illness are potentially conflicting, and discursively constructed, this paper examines whether they are a source of misalignment in interactions between chronic pain patients and their doctors in a pain clinic. The analysis shows these perspectives indeed lead to misalignment, for instance when discussing the relevance of psychotherapy, and lead to intricate uses of argumentative resources to account for the differing perspectives on (the treatment of) pain.

scholarly journals The meaning of chronic pain: a phenomenological analysis

2003 ◽  
Vol 59 (1) ◽  
Author(s):  
B. L. Wade
Keyword(s):  
Chronic Pain ◽  
Phenomenological Analysis ◽  
The Body ◽  
Low Back ◽  
Phenomenological Method ◽  
Life World ◽  
Ways Of Coping ◽  
Chronic Pain Patients ◽  
The Relationship ◽  
Pain Patients

Chronic pain sufferers are frequently misunderstood and stigmatised. The aim of this investigation was to provide a description of the life-world of people with chronic low back pain, using the phenomenological method. Themes which emerged werethat the persistent nature of chronic pain makes it particularlydifficult to endure, arousing a profound fear of the future. Chronic pain causes a disruption in the relationship between the person and the body. The person is forced to function within the constraints of pain and to find ways of coping. Sufferers are unable to fulfil social roles as expected and are forced to revise their goals and activities to accommodate the pain. The distress of their  experience is mediated by the ability to make sense of their condition, finding meaning in the pain itself. This study highlights the value of the phenomenological method in health psychology. Recommendations are made which may be of benefit to people with chronic pain and their families. The multidimensional nature of chronic pain is highlighted and implications for various professionals who work with chronic pain patients are discussed.

The detection of tactile stimuli while observing another in pain in chronic pain patients and controls

2013 ◽  
Vol 26 (1-2) ◽  
pp. 225
Author(s):  
Liesbet Goubert ◽  
Sophie Vandenbroucke ◽  
Vanessa Harrar
Keyword(s):  
Chronic Pain ◽  
Tactile Stimuli ◽  
Chronic Pain Patients ◽  
Pain Patients

Pain Influences Several Levels of Attention

2005 ◽  
Vol 16 (4) ◽  
pp. 235-242 ◽  
Author(s):  
Astrid von Bueren Jarchow ◽  
Bogdan P. Radanov ◽  
Lutz Jäncke
Keyword(s):  
Chronic Pain ◽  
Divided Attention ◽  
Covert Attention ◽  
Attention Task ◽  
Attentional Deficits ◽  
Control Subjects ◽  
Chronic Pain Patients ◽  
Divided Attention Task ◽  
Pain Stimuli ◽  
Pain Patients

Abstract: The aim of the present study was to examine to what extent chronic pain has an impact on various attentional processes. To measure these attention processes a set of experimental standard tests of the “Testbatterie zur Aufmerksamkeitsprüfung” (TAP), a neuropsychological battery testing different levels of attention, were used: alertness, divided attention, covert attention, vigilance, visual search, and Go-NoGo tasks. 24 chronic outpatients and 24 well-matched healthy control subjects were tested. The control subjects were matched for age, gender, and education. The group of chronic pain patients exhibited marked deficiencies in all attentional functions except for the divided attention task. Thus, the data supports the notion that chronic pain negatively influences attention because pain patients` attention is strongly captivated by the internal pain stimuli. Only the more demanding divided attention task has the capability to distract the focus of attention to the pain stimuli. Therefore, the pain patients are capable of performing within normal limits. Based on these findings chronic pain patients' attentional deficits should be appropriately evaluated and considered for insurance and work related matters. The effect of a successful distraction away from the pain in the divided attention task can also open new therapeutic aspects.

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