Anxiety, Fear of Pain Predict Chronic Post-Surgery Pain
(HealthDay News) – State anxiety, psychological measures of amplification of pain, and acute postoperative pain independently predict post-surgical pain at three months, according to a study published in the August issue of The Journal of Pain.
Anne Masselin-Dubois, from INSERM U-987 in Boulogne-Billancourt, France, and colleagues assessed the predictive value of psychological factors for chronic post-surgical pain in patients undergoing total knee arthroplasty for osteoarthritis (89 patients; 65% women; mean age, 69 years; mean baseline pain intensity, 4.7) and breast surgery for cancer (100 patients; 100% women; mean age, 55 years; no preoperative pain). Values were measured before surgery, then two days and three months after surgery. The Spielberger State-Trait Anxiety Inventory, Beck Depression Inventory, and Pain Catastrophizing Scale measured anxiety, depression, and catastrophizing, respectively. The Brief Pain Inventory assessed pain, while neuropathic pain, specifically, was measured with the Douleur Neuropathique 4 questionnaire.
The researchers found that, for all patients (surgeries combined for analysis), the presence of clinically meaningful chronic pain at three months (pain intensity, ≥3/10) was significantly predicted independently by age, pain intensity on day two, and state anxiety. Pain magnification, one of the dimensions of catastrophizing, independently predicted chronic pain intensity. Surgical model and neuropathic characteristics of the pain did not affect the results.
"Thus, state anxiety and pain magnification seem to constitute psychological risk factors for chronic post-surgical pain relevant in all surgical models," the authors write.