Symptom-specific reactivity to stress (lower paraspinal muscle reactivity) among chronic low back pain (CLBP) patients may exacerbate chronic pain. It was hypothesized that among CLBP patients (N = 107) only stress-induced lower paraspinal reactivity, and not reactivity in other indexes, would predict pain severity (PS), and that lower paraspinal reactivity would mediate or moderate links between depression and PS. Electromyogram readings from lower paraspinal and trapezius muscles, systolic and diastolic blood pressures, and heart rate were collected during mental arithmetic (MA) and an anger recall interview. The moderator hypothesis was supported: Only lower paraspinal reactivity during MA was related significantly to PS, but only among patients with high levels of depression. Thus, a profile of lower paraspinal hyperreactivity plus depressed affect may aggravate CLBP.

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This study reports the effects of an inverted position on pulse rate, blood pressure, and deep tendon reflexes of the biceps muscle, triceps muscle, and Achilles tendon. Twenty healthy adults were used as subjects. We collected data both before and after the subjects were in the inverted position for eight minutes on a specially designed tonic labyrinthine inverted table. A significant decrease in systolic blood pressure and all tendon reflexes was observed along with a significant increase in diastolic blood pressure (p less than .05). Pulse rate showed no change. The findings indicate that the inverted position is likely to be effective for decreasing muscle tone and systolic blood pressure. Although this study used healthy subjects, the inverted position may be used as a therapeutic technique, provided the clinician monitors closely the physiological effects on patients.

BACKGROUND:Multidisciplinary programs for treatment of chronic pain are generally effective, yet many patients fail to show significant improvement. The search for predictors of outcome has not explicitly considered sex.OBJECTIVE:To examine mediation and moderation pathways through which sex may predict outcome.DESIGN:Correlational outcome, exploratory, archival study.PARTICIPANTS:A total of 156 chronic pain patients.SETTING:Four-week multidisciplinary pain program.PREDICTOR AND OUTCOME MEASURES:Predictor variables of pain level, activity interference and perceived pain helplessness were culled from patient charts. Outcome was assessed with staff ratings of patient progress.RESULTS:While men responded to treatment more poorly than women, regressions suggested that the greater number of surgeries for men mediated this link. Further analyses revealed that sex acted as a moderator. Among women, perceived pain helplessness was negatively related to outcome, while married women with dissatisfying marriages responded more poorly than unmarried women and women with satisfying marriages. These variables were not significant predictors of outcome among men.CONCLUSIONS:Men and women may be differentially characterized by various risk factors for treatment failure. Moreover, relationships between pretreatment psychosocial factors and outcome may depend on sex.