Psychosocial Factors of Pain

Question 1

Mind vs Body

Answer 1

• Problem is either in the mind of in the body, is now known to be true

Question 2

Beliefs vs Coping

Answer 2

• Good outcome

- Bad outcome

Question 3

Good Outcome

Answer 3

• People who feel they’ve control over pain

Question 4

Bad Outcome

Answer 4

• People who feel the pain is controlled by someone other than themselves

Question 5

Anxiety / Fear Avoidance

Answer 5

• Good and Bad

Question 6

Good (Anxiety / Fear Avoidance)

Answer 6

• If it results in prevention of tissue damage

Question 7

Bad (Anxiety / Fear Avoidance)

Answer 7

• When people have a fear of pain, even though a cause cannot be found

Question 8

Castastrophizing

Answer 8

• Pessimism, helplessness, magnification, maladaptive
• ” I can’t take this anymore”
• ” I know there is something wrong with me”

Question 9

Depression vs Grieving

Answer 9

• Can both cause and be caused by pain

Question 10

Stress

Answer 10

• Acutely

- Prolonged

Question 11

Acutely “stress”

Answer 11

• Can allow a proper response to a threat

Question 12

Prolonged “Stress”

Answer 12

• Can cause multiple adverse effects on the body
• Atrophy
• Changes in brain function

Question 13

Nonorganic Findings (Waddell Signs)

Answer 13

• Based on five tests on indicate if a subject is malingering or wants some type of secondary gain
• Indicates possible psychological testing needs, if 3 of 5 tests are positive
• 60% of Chronic LBP patients present with at least one psychiatric diagnosis
• Tenderness
• Simulation Tests
• Distraction

Question 14

Personality Disorders

Answer 14

• Are not risk factors for developing CPS, however, are associated with a poor prognosis if CPS develops

Question 15

Social Support

Answer 15

• Lack of support is correlated with CPS

- Punishment or a negative response to an individual’s “claim to pain” can increase pain and depression symptoms

Question 16

Tenderness

Answer 16

• Superficial skin tender to touch over a wide surface area of the lumbar region or not localized to one structure

Question 17

Simulation

Answer 17

• Give the pt the impression an exam is being done when in fact it is not.
• Vertical pressure on pt’s skull in standing “reproduces” the pain, however, passive rotation of shoulders with the pelvis, at the same time in the same plain, also “reproduce” the pain

Question 18

Distraction

Answer 18

• Positive findings elicited and compared to the same test in a distracted manner,
• Measure L/S Flexion that “reproduces” pain, however, observe pt pick up a pencil off the floor with no “reproduction” of pain