Linguistic Indicators of Pain Catastrophizing in Patients With Chronic Musculoskeletal Pain

Chronic musculoskeletal pain, catastrophizing, and physical function in adult women were improved after 3-month aerobic-resistance circuit training

Although exercise is beneficial for chronic musculoskeletal pain (CMP), the optimal type and amount of exercise are unclear. This study aimed to determine the impact of circuit training that combines aerobic and resistance exercises on adult women with CMP. A total of 139 women with CMP underwent circuit training for 3 months and were asked to complete the following questionnaires at baseline and 3 months later: Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Roland-Morris Disability Questionnaire (RDQ), Shoulder36, and Knee injury and Osteoarthritis Outcome Score (KOOS). Significant improvements were observed in NRS, PCS, RDQ, and KOOS activities of daily living (ADL) scores after the intervention relative to baseline (p < 0.0001, p = 0.0013, 0.0004, and 0.0295, respectively), whereas shoulder function did not improve. When considering the impact of exercise frequency, NRS scores improved regardless of exercise frequency. Furthermore, PCS, RDQ, and KOOS scores improved in participants who exercised at least twice a week (24 sessions over the course of 3 months). In conclusion, CMP, pain catastrophizing, and physical function in adult female fitness club participants with CMP of NRS 4 or higher improved after 3 months of aerobic-resistance circuit training.

The Language of Pain: Is There a Relationship Between Metaphor Use and Adjustment to Chronic Pain?

OBJECTIVE

Metaphor, frequently used in chronic pain, can function as a communicative tool, facilitating understanding and empathy from others. Previous research has demonstrated that specific linguistic markers exist for areas such as pain catastrophizing, mood, as well as diagnostic categories. The current study sought to examine potential associations between the types of pain metaphors used and diagnostic category, disability, and mood.

DESIGN

Online cross-sectional survey in Sydney, Australia.

SUBJECTS

People with chronic pain (n = 247, age 19-78 years, M = 43.69).

METHODS

The data collected included demographics, pain metaphors, the Brief Pain Inventory (BPI) and the Depression, Anxiety, and Stress Scales (DASS-21). Associations between metaphor source domains, obtained via Systematic Metaphor Analysis, and scores on the BPI, DASS-21, as well as diagnostic group were considered using binary logistic analysis.

RESULTS

Use of different pain metaphors was not associated with pain intensity, however the extent to which pain interfered with daily life did have a relationship with use of metaphorical language. Preliminary support was found for an association between the use of certain pain metaphors and self-reported diagnostic categories, notably Endometriosis, Complex Regional Pain Syndrome, and Neuropathic pain.

CONCLUSIONS

There may be specific linguistic metaphorical markers to indicate pain interference and for particular diagnoses. Appreciation of pain metaphors has potential to facilitate communication and enhance understanding in interactions between clinicians and people with chronic pain.

A linguistic analysis of future narratives in adolescents with Complex Regional Pain Syndrome and their pain-free peers

BACKGROUND

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that often develops after injury, with a typical onset in adolescence. The impact of chronic pain is far-reaching, with many adolescents reporting atypical developmental trajectories compared with peers. Social Comparison Theory offers a framework for understanding how such comparisons influence well-being, whereby a heightened sense of disparity places adolescents at risk of poor cognitive, affective and social outcomes. Using a novel linguistic analysis programme, this study aims to investigate cognitive, affective and social language used by adolescents with CRPS in comparison to their peers during a task reflecting on their futures.

METHODS

A story completion task was completed by adolescents with CPRS (n = 49) and adolescents without pain (n = 48). This task involved asking adolescents to describe their imagined future. Narratives were analysed using a novel linguistic analysis programme, focusing on the cognitive, affective and social dimensions.

RESULTS

Findings revealed significant group differences in how adolescents with CRPS described their imagined futures. Adolescents with CRPS used significantly fewer positive affect and more negative affect, anger and sadness words, and greater insight and discrepancy words. No significant groups differences were found for social words.

CONCLUSIONS

Substantial differences in cognitive and affective words were found between adolescents with and without CRPS. Findings provide novel insights into current understandings of cognitive, affective and social processes in adolescents living with chronic pain, particularly with regard to adolescent developmental trajectories, and may in turn highlight potential targets in psychosocial interventions for adolescents living with chronic pain.

SIGNIFICANCE

Social comparisons are commonly undertaken by adolescents with CRPS in relation to peers, increasing risk for poor cognitive, affective and social outcomes. Findings promote the potential importance of targeting psychosocial factors in treatments for paediatric chronic pain.