Thinking of events as a catastrophe, fear, and being depressed appear to be major predictors of whether acute pain from surgery or injury will morph into chronic pain, researchers reported at the annual meeting of the American Academy of Pain Medicine. For patients with low back pain, “castastrophizing has been found to be seven times more powerful than any other predictor in predicting the transition from acute to chronic pain,” said Sean Mackey, MD, PhD, chief of the pain management division at Stanford University.
Fear also appears to play a role, Mackey commented. “Those who had more fear during an acute low back pain episode were much more likely to ultimately over-predict the amount of pain they had, which ultimately led to significant increase in fear-avoidance behaviors, with subsequent worsening of symptoms, increase in duration of pain, and increase in disability,” he said.
Depression and anxiety also had similar effects. “About 30% to 65% of patients who have chronic pain also have comorbid depression,” Mackey added.
Being optimistic was linked to better recovery and higher quality of life (Annals of Surgery 2007; 245: 487-494).
As part of my chronic pain management strategy, I use therapeutic lifestyle changes including diet, nutrition, attitudinal discussions and gentle exercise. The laser modality is still very, very new to most clients and definitely needs to be tried by chronic pain patients.