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Factors Associated With Clinical Pain Catastrophizing in Military Personnel With Chronic Back Pain: A Retrospective
Juliana S Ee1, Godwin Y Dogbey2, Austin T Tannenbaum1
1Department of Family Medicine, Womack Army Medical Center, Fort Bragg, NC 28310, United States.
Introduction:
Pain catastrophizing has been shown to negatively affect health outcomes in chronic musculoskeletal pain. This study examined factors associated with clinical levels of pain catastrophizing that could guide effectiveness of pain control and management.
Materials And Methods:
The study was a cross-sectional, retrospective review of intake surveys completed by 158 soldiers (31.3 ± 7.1 years old) seen at Womack Interdisciplinary Pain Management Center for chronic back or low back pain. Measurements included the Pain Catastrophizing Scale (PCS), Defense and Veterans Pain Rating Scale, and Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference Short Form, and the depression (PHQ-9) and anxiety (GAD-7) scales from the Patient Health Questionnaire. The patients were categorized into clinical (n = 65) vs. non-clinical (n = 93) pain catastrophizing groups. From the PCS developer, a total PCS score of 30 or above represents clinical level of catastrophizing. Data were analyzed using descriptive statistics and independent sample t-tests.
Results:
Statistically significant difference was found between the clinical and non-clinical pain catastrophizing groups on scores of pain intensity (6.1 vs. 4.9, P < .001) and pain effect on activity (6.7 vs. 5.3, P < .001), sleep (6.8 vs. 4.7, P < .001), and stress level (7.2 vs. 4.5, P < .001). Pain interfered in functioning to a greater extent in the clinical group than the non-clinical group (19.3 vs. 15.0, P < .001). The clinical group also reported greater severity of depression (13.1 vs. 4.8, P < .001) and anxiety (11.1 vs. 3.5, P < .001) than the non-clinical group.
Conclusions:
As pain catastrophizing thoughts increase in frequency and intensity, they can lead to long-lasting detrimental effects on overall quality of life and coping. The findings underscore the importance of targeting clinical pain catastrophizing in chronic pain treatment, given its link with numerous pain-related factors that include functioning and mental health.
