THE PSYCHOLOGICAL IMPACT OF PAIN

by John Allen, OMS IV

A certain amount of pain is a normal part of living.  After all, pain is how your body warns you that it is injured or approaching an injury.  An individual’s experience of this pain will vary somewhat depending on how they have learned to interpret and interact with pain.  However, sometimes pain will continue out of proportion to the original cause due to inflammation, chronic disease, or trauma.

Chronic pain

Is a very common condition in the general population that can have a negative impact on a person’s quality of life. Common types of chronic pain include low back (lumbar) pain, mid-back (thoracic) pain, neck (cervical) pain, certain types of headache, knee pain, and sciatica (nerve pain radiating from the back to the posterior thigh).  Certain kinds of pain, such as low back pain, increase with age, with studies estimating between 21 and 75% of those over the age of 60 experience chronic low back pain and as many as 80% of adults over 65 experience some kind of chronic pain.

Mental health issues 

such as anxiety, depression, and mood disorders are also common in the general population with up to 30% of people experiencing one of these problems sometime in their lifetime.  Depression includes a variety of characteristic features such as depressed mood, sleep disturbance, loss of interest in regular activities, low energy, poor concentration, and changes in appetite (loss or gain). Anxiety is primarily characterized by feelings of fear or excessive worry and may include generalized anxiety or specific fears.

Chronic pain and mental health issues 

Commonly occur together. For many people they can feed into each other creating a cycle that can be difficult to break out of.  Significant pain experienced while performing normal activities can worsen depression and depression can also lead to more pain.  Fear of re-experiencing something painful can feed into a condition of anxiety and the anxiety can make pain worse. 

With all that said, there is room for hope for someone experiencing chronic pain and mental health difficulties.  Many options for treatment exist which can be effective at helping address both pain and accompanying depression or anxiety including:

  • Psychotherapy (Counseling)
  • Cognitive-behavioral therapy (CBT) for stress reduction
  • Biofeedback
  • Medications such as antidepressants or some anti-seizure medications

References:

  • de Souza IMB, Sakaguchi TF, Yuan SLK, et al. Prevalence of low back pain in the elderly population: a systematic review. Clinics (Sao Paulo). 2019;74:e789. Published 2019 Oct 28. doi:10.6061/clinics/2019/e789
  • Wong AY, Karppinen J, Samartzis D. Low back pain in older adults: risk factors, management options and future directions. Scoliosis Spinal Disord. 2017;12:14. Published 2017 Apr 18. doi:10.1186/s13013-017-0121-3
  • Zis P, Daskalaki A, Bountouni I, Sykioti P, Varrassi G, Paladini A. Depression and chronic pain in the elderly: links and management challenges. Clin Interv Aging. 2017;12:709-720. Published 2017 Apr 21. doi:10.2147/CIA.S113576
  • Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication [published correction appears in Arch Gen Psychiatry. 2005 Jul;62(7):709. Merikangas, Kathleen R [added]]. Arch Gen Psychiatry. 2005;62(6):617-627. doi:10.1001/archpsyc.62.6.617
  • Steel Z, Marnane C, Iranpour C, et al. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. Int J Epidemiol. 2014;43(2):476-493. doi:10.1093/ije/dyu038
  • Henschke N, Kamper SJ, Maher CG. The epidemiology and economic consequences of pain. Mayo Clin Proc. 2015;90(1):139-147. doi:10.1016/j.mayocp.2014.09.010
  • Hooten WM. Chronic Pain and Mental Health Disorders: Shared Neural Mechanisms, Epidemiology, and Treatment. Mayo Clin Proc. 2016;91(7):955-970. doi:10.1016/j.mayocp.2016.04.029
 

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