Pain measurement and pain behavior

This study examined relationships between chronic pain patients' ratings of pain severity, and other patient ratings about severity of associated impairment, and a series of behavioral measures of health care utilization and activity patterns. Prior to being evaluated, a sample of 150 chronic pain patients completed diary forms on which they recorded severity of pain on a 0-10 scale. Subjects were divided into high-medium-low on mean pain ratings, and were compared on the other measures obtained either from diary forms or at time of evaluation. Patient generated statements about severity of pain and extent of functional impairment from pain interrelated positively. However, these measures showed few relationships to medication consumption, health care utilization, diary recorded activity level, or to patient reported frequency counts of engaging in a set of commonplace activities. The results were interpreted to suggest that, in chronic pain, there may be a questionable relationship between what people say about their pain and what they do. Accordingly, the evaluation of chronic pain should include analyses of patient behavior.