Abstract
Pain catastrophizing, a pattern of negative cognitive-emotional responses to actual or anticipated pain, maintains chronic pain and undermines response to treatments. Currently, precisely how pain catastrophizing influences pain processing is not well understood. In experimental settings, pain catastrophizing has been associated with amplified pain processing. This study sought to clarify pain processing mechanisms via experimental induction of pain catastrophizing. Forty women with chronic low back pain were assigned in blocks to an experimental condition, either a psychologist-led 10-minute pain catastrophizing induction or a control (10-minute rest period). All participants underwent a baseline round of several quantitative sensory testing (QST) tasks, followed by the pain catastrophizing induction or the rest period, and then a second round of the same QST tasks. The catastrophizing induction appeared to increase state pain catastrophizing levels. Changes in QST pain were detected for two of the QST tasks administered, weighted pin pain and mechanical allodynia. Although there is a need to replicate our preliminary results with a larger sample, study findings suggest a potential relationship between induced pain catastrophizing and central sensitization of pain. Clarification of the mechanisms through which catastrophizing affects pain modulatory systems may yield useful clinical insights into the treatment of chronic pain.
Highlights
More than 100 million Americans [1] and approximately 1.5 billion people in the world [2] suffer from chronic pain, with chronic low back pain being the leading cause of disability globally [3]
Prior literature has mixed results on which types of quantitative sensory testing (QST) tasks correlate with pain catastrophizing levels, some prior findings do appear to align with the results found in this pilot
The prior literature examining the impact of catastrophizing on evoked pain are somewhat inconsistent and the relationship has rarely been examined in clinical populations
Summary
More than 100 million Americans [1] and approximately 1.5 billion people in the world [2] suffer from chronic pain, with chronic low back pain being the leading cause of disability globally [3]. Many patients report significant pain and disability, but clear evidence of physical abnormalities that explain the onset and maintenance of pain is often absent [5]. Modern clinical models of pain have evolved to include other potential causes and contributors to pain, such as psychological factors and aberrancies in central nervous system function. The intimate interaction between the physical and the psychological components of the pain experience has been well documented in pain literature [6] and there remains an urgent need to better characterize the psychological factors contributing to the onset and maintenance of chronic low back pain in order to develop better-targeted and more effective treatments
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