Memories of chronic pain and perceptions of relief

被引:124
作者
Feine, JS
Lavigne, GJ
Dao, TTT
Morin, C
Lund, JP
机构
[1] McGill Univ, Fac Dent, Montreal, PQ H3A 2B2, Canada
[2] McGill Univ, Fac Med, Dept Biostat & Epidemiol & Occupat Hlth, Montreal, PQ, Canada
[3] McGill Univ, Jewish Gen Hosp, Lady Davis Inst Med Res, Montreal, PQ H3T 1E2, Canada
[4] Univ Montreal, Fac Med Dent, Montreal, PQ H3C 3J7, Canada
[5] Univ Montreal, Ctr Rech Sci Neurol, Montreal, PQ H3C 3J7, Canada
[6] Univ Toronto, Fac Dent, Toronto, ON, Canada
[7] McGill Univ, Fac Med, Dept Physiol, Montreal, PQ, Canada
基金
英国医学研究理事会;
关键词
chronic pain; memory; relief; psychophysics;
D O I
10.1016/S0304-3959(98)00089-X
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Clinicians and researchers often ask patients to remember their past pain. They also use patient's reports of relief from pain as evidence of treatment efficacy, assuming that relief represents the difference between pretreatment pain and present pain. We have estimated the accuracy of remembering pain and described the relationship between remembered pain, changes in pain levels and reports of relief during treatment. During a 10-week randomized controlled clinical trial on the effectiveness of oral appliances for the management of chronic myalgia of the jaw muscles, subjects recalled their pretreatment pain and rated their present pain and perceived relief. Multiple regression analysis and repeated measures analyses of variance (ANOVA) were used for data analysis. Memory of the pretreatment pain was inaccurate and the errors in recall got significantly worse with the passage of time (P < 0.001). Accuracy of recall for pretreatment pain depended on the level of pain before treatment (P < 0.001): subjects with low pretreatment pain exaggerated its intensity afterwards, while it was underestimated by those with the highest pretreatment pain. Memory of pretreatment pain was also dependent on the level of pain at the moment of recall (P < 0.001). Ratings of relief increased over time (P < 0.001), and were dependent on both present and remembered pain (Ps < 0.001). However, true changes in pain were not significantly related to relief scores (P = 0.41). Finally, almost all patients reported relief, even those whose pain had increased. These results suggest that reports of perceived relief do not necessarily reflect true changes in pain. (C) 1998 International Association for the Study of Pain. Published by Elsevier Science B.V.
引用
收藏
页码:137 / 141
页数:5
相关论文
共 20 条
[1]   DIAGNOSIS AND TREATMENT OF PERSISTENT PAIN AFTER TRAUMA TO THE HEAD AND NECK [J].
BENOLIEL, R ;
ELIAV, E ;
ELISHOOV, H ;
SHARAV, Y .
JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 1994, 52 (11) :1138-1147
[2]   A DOUBLE-BLIND, MULTICENTER, PLACEBO CONTROLLED TRIAL OF LORNOXICAM IN PATIENTS WITH OSTEOARTHRITIS OF THE HIP AND KNEE [J].
BERRY, H ;
BIRD, HA ;
BLACK, C ;
BLAKE, DR ;
FREEMAN, AM ;
GOLDING, DN ;
HAMILTON, EBD ;
JAYSON, MIV ;
KIDD, B ;
KOHN, H ;
MILLION, R ;
OLLIER, S ;
SMITH, I ;
WILLIAMS, BD ;
WOOLF, AD .
ANNALS OF THE RHEUMATIC DISEASES, 1992, 51 (02) :238-242
[3]   ANALYSIS OF GENDER EFFECTS ON PAIN PERCEPTION AND SYMPTOM PRESENTATION IN TEMPOROMANDIBULAR PAIN [J].
BUSH, FM ;
HARKINS, SW ;
HARRINGTON, WG ;
PRICE, DD .
PAIN, 1993, 53 (01) :73-80
[4]   PATTERNS OF CONSCIOUS FAILURE TO PROVIDE ACCURATE SELF-REPORT DATA IN PATIENTS WITH LOW-BACK-PAIN [J].
CHAPMAN, SL ;
BRENA, SF .
CLINICAL JOURNAL OF PAIN, 1990, 6 (03) :178-190
[5]   THE EFFICACY OF ORAL SPLINTS IN THE TREATMENT OF MYOFASCIAL PAIN OF THE JAW MUSCLES - A CONTROLLED CLINICAL-TRIAL [J].
DAO, TTT ;
LAVIGNE, GJ ;
CHARBONNEAU, A ;
FEINE, JS ;
LUND, JP .
PAIN, 1994, 56 (01) :85-94
[6]   MEMORY FOR PAIN - RELATION BETWEEN PAST AND PRESENT PAIN INTENSITY [J].
EICH, E ;
REEVES, JL ;
JAEGER, B ;
GRAFFRADFORD, SB .
PAIN, 1985, 23 (04) :375-379
[7]   An assessment of the efficacy of physical therapy and physical modalities for the control of chronic musculoskeletal pain [J].
Feine, JS ;
Lund, JP .
PAIN, 1997, 71 (01) :5-23
[8]   PAIN STATE AS ARTIFACT IN THE PSYCHOLOGICAL-ASSESSMENT OF RECURRENT HEADACHE SUFFERERS [J].
HOLROYD, KA ;
FRANCE, JL ;
NASH, JM ;
HURSEY, KG .
PAIN, 1993, 53 (02) :229-235
[9]  
*I MED, 1987, PAIN DIS CLIN BEH PU, P306
[10]   THE INFLUENCE OF PHYSICAL AND PSYCHOSOCIAL FACTORS ON ACCURACY OF MEMORY FOR PAIN IN CHRONIC PAIN PATIENTS [J].
JAMISON, RN ;
SBROCCO, T ;
PARRIS, WCV .
PAIN, 1989, 37 (03) :289-294