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Cardiovascular activity and chronic pain severity

Dmitry M Davydov1, Solomon Perlo2

  • 1Laboratory of Neuroimmunopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 8 Baltiyskaia ul., Moscow 125315, Russia.

Physiology & Behavior
|October 6, 2015
PubMed

Insights

Cardiovascular reactivity, measured during a postural challenge, can objectively indicate chronic pain severity. Stronger heart rate responses suggest better protection against pain symptoms, aiding in patient assessment.

Area of Science:

  • Biobehavioral science
  • Cardiovascular physiology
  • Pain medicine

Background:

  • Objective markers for chronic pain severity are lacking.
  • Current assessment often relies on subjective patient reports, risking over or underestimation of suffering.
  • Cardiovascular (CV) reactivity may serve as a reliable objective index.

Purpose of the Study:

  • To test if cardiovascular reactivity strength predicts chronic pain severity.
  • To investigate CV reactivity in response to social evaluative threat and orthostatic challenge.
  • To determine if CV reactivity is a reliable index of pain-related complaints.

Main Methods:

  • CV reactivity and response styles were measured in 16 women and 34 men with chronic pain.
  • Measurements were taken twice on the same day during a medical examination including psychosocial evaluation.
  • Orthostatic challenge involved measuring CV reactivity in response to standing up from a lying position.

Main Results:

  • A decrease in systolic blood pressure (SBP) from session 1 to 2 occurred in low pain severity subjects, but not high.
  • Pain catastrophizing/magnification correlated with SBP increase; emotional distress correlated with SBP decrease.
  • Greater heart rate reactivity to orthostatic challenge indicated better protection against chronic pain symptoms.

Conclusions:

  • A biobehavioral protocol can measure chronic pain suffering and protection.
  • This protocol assesses pain across physical, emotional, and cognitive dimensions.
  • Objective CV reactivity measures offer a new dimension in chronic pain assessment.
Abstract

Keywords:
Blood pressureChronic pain severityEmotional distressOrienting behaviorOrthostatic stressPain magnification

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