Pain, Pain, Go Away...

Nobody wants to feel pain. In fact, the word itself is filled with so much negativity that if something is thought to have caused pain, then we try everything to avoid it. In one of the lectures that we had, pain is considered as our body's way of telling us that something is wrong. What's great about it is that once we have learned about the problem, then we can easily find a solution before things get worse.

However, experience tells us that not all pain can be resolved right away. Pain could get worse and may interfere with our normal day-to-day functioning. Even a toothache could make a child skip school. Additionally, negative emotions such as depression, anxiety and anger relates closely with pain. But, the causal relationship between pain and negative emotions is still unclear. Does pain cause us to have those negative emotional states, or does the negative emotion that we have worsen the experience of pain? It's like the dilemma on which came in first, the chicken or the egg, that if resolved could have serious implications.


A group of researchers lead by Gabriel Tan (2008) studied the relationship between negative emotions (depression, anxiety and anger) with chronic pain and functioning. Using a structural equation modeling approach (LISREL) the hypothesis that negative emotions are significantly associated with pain and functioning was tested.

126 patients with chronic noncancer pain (referred to the Integrated Pain management Program (IPMP) of the Houston VA Medical Center) participated in the study. The negative emotional states measured were depression, anxiety and anger symptoms using The Center for Epidemiological Studies Depression Scale (LES-D), the State Anxiety and the State Anger subscales of the State-Trait Personality Inventory, respectively. Likewise, disability, pain interference and severity were measured. Then, the relationship between the said variables was examined through the Linear structural relations (LISREL) program.

Results are consistent with the hypothesis that negative emotuional states are closely related with pain and functioning. More specifically, results support a model that pain severity directly affects interference, and indirectly influences disability, depression, anxiety and anger. Moreover, disability is directly affected by anxiety and indirectly influenced by depression. Thus, when a person is suffereing from pain, he/she may avoid work for fear of exacerbation. The more a person reports depression, anxiety, pain severity and interference, the more the person is likely to become disabled.


Although the findings prove to be useful in the treatment of pain and disability, the generalizability of the results are limited because the sample used mainly include male veterans with a long history of chronic pain.

Finally, this research tells us that pain interacts with other emotions, specially negative ones, that if left alone could lead to disability. This reminds us that one thing we could do to help those suffering from pain is to support them and give them no reason to develop those negative emotions. It is also inspiring to see people that despite their pain and disability continues to live a meaningful and happy life.
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References:

Tan, G., Jensen, M. P., Thornby, J., & Sloan, P. A., Negative emotions, pain, and functioning. Psychological Services, Vol 5(1), Feb, 2008. pp. 26-35. Retrieved from EBSCOhost.

Images:

http://www.ehealthyland.com/health/dental-care/dental-care-what-is-toothache-in-children-children-toothache.html

http://topnews.net.nz/content/210483-chronic-pain-could-be-treated-blocking-enzyme-researchers