There's been a lot of discussion in pain management circles about the psychological aspects of chronic pain. Patients with dementia are a hot topic in this area; now more information is coming out about these persons, and those with other cognitive deficits including those with attention deficit and/or impaired executive functions.
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A study published in January 2014 edition of Brain helps to illustrate how and why this is the case.This study looked at 189 subjects who ranged in age from 18 to 85 years. Study subjects were all about to undergo knee replacement (for osteoarthritis) or breast cancer surgery.
And here's where it becomes interesting--in the knee replacement group, 84% of the patients had "clinically meaningful" pain levels prior to procedure. Six to twelve months after surgery, 38-39% of these subjects were still reporting significant pain. In the breast cancer group, none of the subjects complained of significant pain before surgery, but six to twelve months later, 18 to 20% of the group reported being in pain.
The researchers noted which of these persons had various types of cognitive impairments before surgery--attention deficit disorder, dementia, Parkinson's related issues, brain trauma, and the like. And it turns out that there was a direct correlation between these conditions and post-operative pain issues. This is not surprising, the researchers say--because the areas of the brain affected by cognitive impairment are also involved in pain modulation.
This strongly suggests that a large component of the pain response is due to impairment of one's coping skills. While this study does not make recommendations one way or another, it certainly seems that any or all efforts focused on improving one's ability to cope--especially those with cognitive impairment--can go a long way in improving pain management.
You can read about this study in more detail by clicking here.
Sources: Psychiatric News; Wikimedia
A study published in January 2014 edition of Brain helps to illustrate how and why this is the case.This study looked at 189 subjects who ranged in age from 18 to 85 years. Study subjects were all about to undergo knee replacement (for osteoarthritis) or breast cancer surgery.
And here's where it becomes interesting--in the knee replacement group, 84% of the patients had "clinically meaningful" pain levels prior to procedure. Six to twelve months after surgery, 38-39% of these subjects were still reporting significant pain. In the breast cancer group, none of the subjects complained of significant pain before surgery, but six to twelve months later, 18 to 20% of the group reported being in pain.
The researchers noted which of these persons had various types of cognitive impairments before surgery--attention deficit disorder, dementia, Parkinson's related issues, brain trauma, and the like. And it turns out that there was a direct correlation between these conditions and post-operative pain issues. This is not surprising, the researchers say--because the areas of the brain affected by cognitive impairment are also involved in pain modulation.
This strongly suggests that a large component of the pain response is due to impairment of one's coping skills. While this study does not make recommendations one way or another, it certainly seems that any or all efforts focused on improving one's ability to cope--especially those with cognitive impairment--can go a long way in improving pain management.
You can read about this study in more detail by clicking here.
Sources: Psychiatric News; Wikimedia
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