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Related Concept Videos

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Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
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Author Spotlight: Quantifying Pain Experience – An Illustrative Approach Using the Pain Body Diagram
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The relationship between guarding, pain, and emotion.

Temitayo Olugbade1, Nadia Bianchi-Berthouze1, Amanda C de C Williams2

  • 1University College London Interaction Centre (UCLIC), University College London, London, United Kingdom.

Pain Reports
|October 4, 2019
PubMed
Summary

Pain-related guarding in chronic pain is linked to anxiety, not directly to pain intensity. Interventions should focus on reducing anxiety and improving movement confidence to help patients increase activity levels.

Keywords:
AnxietyChronic painKinesiophobiaPain behavior

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Area of Science:

  • Behavioral Medicine
  • Pain Management
  • Psychology

Background:

  • Pain-related behaviors like guarding are often overlooked in chronic pain management.
  • These behaviors can limit activity and perpetuate pain and disability.
  • Understanding the interplay of beliefs, emotions, and pain is crucial for effective treatment.

Purpose of the Study:

  • To investigate the relationships between guarding, pain, anxiety, and movement confidence in individuals with chronic pain.
  • To clarify how these factors influence everyday movements.

Main Methods:

  • Physiotherapists assessed guarding behaviors from video recordings of individuals with chronic pain and healthy controls during specific movements.
  • Bayesian modeling was employed to analyze the associations between guarding and self-reported pain, anxiety, emotional distress, and observer-rated movement confidence.

Main Results:

  • Guarding behavior was not solely dependent on pain intensity but was significantly mediated by anxiety.
  • Lower levels of pain, anxiety, and distress, along with higher movement self-efficacy, were associated with the absence of guarding.
  • Guarding occurred across various levels of pain and distress, highlighting the complex relationship.

Conclusions:

  • Interventions targeting anxiety reduction may be more effective for pain-related guarding than those solely focused on pain relief.
  • Shifting focus from the quantity of movement to the quality of movement (how people move) is essential for increasing activity in chronic pain populations.