It only gets worse … or does it? The relationship between pain duration and psychological pain factors

Patients with chronic pain face significant stigma in interactions with the public and health professionals. A common assumption is that the longer one's pain continues, the more psychological its nature. This study investigated the relationship between psychological variables and duration of pain symptoms.

This observational study included outcomes of pain duration and severity, Pain Catastrophizing Scale (PCS), Psychological Inflexibility in Pain Scale (PIPS), and Patient Health Questionnaire (PHQ8). Participants recruited completed all outcomes via an online survey.

Correlation analysis showed that as duration increases, total PCS (r = -.097), PCS - Magnification (r = -.126), and PCS - Helplessness (r = -.088) scores decrease. There were no differences in pain duration between participants with high versus low levels of pain catastrophizing. For PCS - Magnification, there was a significant difference between the 1-3-year and >10-year groups (p = .012). There was a significant difference in PIPS between the 1-3-year group and 7-10-year group (p = .032) and significant differences on the PHQ8 between the 1-3-year group and the 3-6-year group (p = .007) as well as between the 1-3-year group and the >10-year group (p = .032).

The stigma associated with pain chronicity extends into the clinical setting, leading to undertreatment and dismissal of patient symptoms. This study emphasizes that a relationship between pain behaviors, psychological symptoms, and pain chronicity cannot be assumed during encounters with patients in pain.