As physicians become more aware of the connection between chronic pain and patient perception, there have been many studies investigating how the link can help relieve chronic pain. It is important to understand this connection because it can lead to better pain control through more targeted treatment, and it can help physicians and researchers better understand the illness or disorder causing the pain.
In this study, researchers wanted to learn whether patients could improve in function after participating in a cognitive awareness program. Recruited from a 4-week group pain management program in New Zealand, 76 patients (49 women) agreed to participate in the study. The average age of participants was 42 years and they experienced an average of 7 years of pain. More than half (57 percent) were unemployed because of the pain. Their participation consisted of completing questionnaires as they went through the program and after its completion. Of the 76 patients who began the study, 64 patients completed questionnaires throughout the program to the end, 58 completed them at 6 months after the program’s end.
The questionnaires were chosen to evaluate overall health, mental and physical, perceptions about illness, and reaction to pain. The Short Form Health Questionnaire or the SF-36, measured the outcome after the study (28 weeks). The SF-36 looked at the mental and physical components, the abilities to perform every day tasks, how the pain was interfering with the patients’ life, and the extent of body pain. The Revised Illness Perceptions Questionnaire, or IRQ-R, measured how the patients represented their pain: negative representations, timelines, and emotional distress. The Pain Catastrophizing Scale measured the tendencies of patients to feel and expect the worst from the pain, from catastrophizing the pain. Finally, the Pain Vigilance and Awareness Questionnaire was used to assess hypervigilance or awareness of pain.
The researchers found the pain program resulted in an improvement in disability as patients felt better both mentally and physically over the 4-week program period and the 6 months following, although there was a small loss in treatment gains during the follow-up period. The authors pointed out, “If patients are less distressed by their pain, their pain is less likely to interfere with their ability to socialize and their general sense of well-being.”
Interestingly, the researchers also found that participating in the program didn’t affect all aspects of pain. For example, the timeline and control beliefs about pain were not changed, and even dropped in some cases. Nor was there a significant change in terms of how patients were aware or hypervigilant of the pain.
The authors admit there were some limitations to their study, including the small sample size and the inability to determine cause and effect. However, the authors do feel that this study do note an improvement in physical functioning of 26 percent, and in mental functioning by 23 percent.