One topic that comes up often when I meet with clients about their Social Security Disability claims is pain. I’ve always said that pain makes depression worse and depression makes the pain worse. Here’s an article where researchers have proven this. The researchers found that patients with pain and restricted function had more depression. The presence of depression also predicted which patients would worsen. Patients who had the highest optimism had least pain. Knowing this affects the treatment a patient could receive to treat the pain they’re having.
Biopsychosocial Chronic Pain
Chronic Pain and Ageing, meet Psychology. Or Biopsychosocial Psychology.
Osteoarthritis (OA) is a highly prevalent condition, representing the leading cause of disability andchronic pain among older members of the population. In other words, we all have something to look forward to.
However, the degree of chronic pain suffered is varied, and does not always correlate with the changes seen on x-ray, or even MRI. Psychosocial factors are consistently associated with the symptomatology of OA: Pain and restricted function are associated with more depressive symptoms, and the existence of depression has predicted which patients might worsen over time, including who would respond better to a given treatment.
In order to understand chronic pain—including how best to treat chronic pain—the medical world needs to understand the psychological make-up of the chronic pain patient. This psychological assessment is not complete without an interpretation of how a patient’s experience of pain is related to changes in central pain processing, as dysfunctional central sensitization and descending pain inhibition have been observed in OA patients, supporting the theory that there is a large component of pain related to these phenomena. Researchers from the University of Alabama and the University of Florida published the results of a study of psychological profiles in patient with knee OA in the November, 2013 issue of “Arthritis Care & Research,” and their relationship to pain and sensory characteristics associated with pain perception.
Indeed, the researchers did find different psychological profiles in patients with knee OA; but grouping individuals together based on psychological characteristics found significant differences in clinical pain, supporting the need for a biopsychosocial model of the treatment and evaluation of pain in OA patients.