Chronic Pain and Your Brain
Summer of Research project by Nicola Kluger, AUT, supervised by Dr Andrea Burri.
Chronic pain (any pain that lasts longer than 12 weeks) can be debilitating. As you can imagine, chronic pain is a rather broad term. It can have many different causes, which makes treatment difficult. This means more hospital visits, more medication, and more cost for both the patient and healthcare provider.
Nicola Kluger saw room for improvement in the treatment of patients suffering from chronic pain. She felt that in order to provide a better service, it is necessary to better understand the patients. Nicola spent time working with the Waitemata District Health Board’s (WDHB) chronic pain service during her summer research project. Patients that are referred to the chronic pain service are asked to fill out nine questionnaires during their journey down the treatment pathway.
The questionnaires are as follows:
- Brief Pain Inventory (BPI)
- Short From McGill Pain Questionnaire v2 (SFMPQ-2)
- Pittsburgh Sleep Quality Index (PSQI)
- Depression, Anxiety and Stress Scale – 21 items (DASS-21)
- Pain Self-Efficacy Questionnaire (PSEQ)
- Tampa Scale of Kinesphobia – 11 (TKS-11)
- Pain Catastrophizing Scale (PCS)
- Chronic Pain Acceptance Questionnaire (CPAQ)
- Standardised questions on demographics, employment, health care utilisation and medication use.
The information collected from these studies is used to treat patients at an individual level, but it had not previously been analysed to provide a general view of the needs of those suffering from chronic pain. The aims of Nicola’s project were twofold:
- Examine and understand the types of patients that use the WDHB chronic pain service.
- Gain insight into the various psychological, behavioural and/or social factors associated with the outcomes of chronic pain.
After analysing the questionnaire data collected between 2012-2015, Nicola was able to pinpoint some significant differences in variables between men/women and Māori/NZ European. Further research is needed to find out exactly what these differences mean, but this result could provide valuable insight into individual patient needs that may not currently be met.
Nicola also looked at the relation of chronic pain to the psychological aspects of developing disabilities, sleep quality, and pain acceptance. According to her research model, focussing on mental issues such as anxiety and depression, as well as promoting positive coping strategies, could influence the development of pain disability. Nicola’s research shows anxiety and depression are also linked to sleep quality and pain severity. The overall theme of her findings suggests that a patient’s psychology is closely related to their interpretation of pain and how it affects their life.
As more research is completed in this field, clinicians will gain a better idea of how to treat individual patients suffering from chronic pain. Everyone deals with pain differently, and the more information that is available about a patient, the more precise healthcare will become.
Nicola Kluger is among a group of students who took part in the summer of research programme funded by Precision Driven Health. This month we are featuring a blog series examining these projects. While at an elementary stage and considered to be a ‘proof of concept’, these projects offer fresh insights into what the world of healthcare will look like when precision medicine is fully implemented.
PDH is New Zealand’s unique health data science research partnership.