Catastrophizing an indendent risk factor for widespread chronic pain

A recent study this month February 2024 found ‘Pain catastrophizing appears to be an independent risk factor for progression to chronic widespread pain among patients with chronic low back pain. These findings provide a rationale for interventions aimed at reducing pain catastrophizing, including rumination, magnification, and helplessness, among patients with chronic low back pain.’

Catastrophizing means to imagine the worst possible outcome of an action or event. Pain catastrophizing as defined by Quartana in this research article is characterized by the tendency to magnify the threat value of a pain stimulus and to feel helpless in the presence of pain, as well as by a relative inability to prevent or inhibit pain-related thoughts in anticipation of, during, or following a painful event.

There are 3 components to what’s called the PCS (Pain Catastrophizing Scale). They are rumination, magnification, and helplessness. I screen all new patients for catastrophizing using the PCS. It’s an important measure to look at as more and more research show the impact of catastrophizing on somatic symptoms in the body. In fact, surgeons are starting to screen their patients for castastrophizing as studies indicate it is a risk factor for poor surgical outcomes and elevated post-operative pain.