Last week, we discussed some of the psychological components of pain, and the potent effect emotion and attitude can have on the day-to-day management of your pain. Many patients coping with chronic pain experience kinesiophobia, an irrational fear of reinjuring oneself or exacerbating pain by participating in physical activity.
One study of patients with foot and ankle pain found that out of movement-related fear, pain intensity, and range of motion deficit, fear was by far the greatest predictor of disability status (http://1.usa.gov/1fXzxN5). Clearly, fear of movement plays an important role in the quality of life of patients living with pain.
Managing pain more successfully as reflected in continuing to work and be involved in life is associated with less fear than those with lower levels of functioning when all other metrics are also considered. A review of seven studies which examined patients with chronic musculoskeletal pain who chose to continue working found that these patients were significantly more likely to have low scores for both emotional distress and perceived disability (http://1.usa.gov/H4v9gc).
Treatments that address both the physical and emotional aspects of pain can produce better outcomes. A study of 130 patients who had undergone a spinal fusion found that patients who participated in a rehabilitation program that included cognitive-behavioral therapy to address kinesiophobia and catastrophizing as well therapeutic exercise faired significantly better than those who participated in a program consisting only of therapeutic exercise. The psychological intervention was found to reduce dysfunctional thoughts and enhance quality of life for up to one year after treatment ended (http://1.usa.gov/17M2T91).
It is apparent that attitude – especially beliefs about movement – impacts the quality of life for patients in pain. Those who maintain a positive outlook and a healthy perspective on movement, though not necessarily reporting reduced levels of pain, do show an increase in function.
Filed under: pain management
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