A psychosocial and behavioral comparison of reflex sympathetic dystrophy, low back pain and headache patients

Abstract

Based primarily on anecdotal evidence, patients with reflex sympathetic dystrophy (RSD) have often been suspected of having a high degree of psychosocial disturbance prior to the onset of symptoms as well as in reaction to the disorder. In the present study, patients presenting to a pain center with RSD were compared to patients with low back (LBP) and headache pain (HAP) on a variety of self-reported demographic, behavioral, pain, and mood measures. Typical of most patients experiencing chronic pain, all three groups demonstrated elevations indicative of pain, emotional distress, and behavioral disturbance. However, although the RSD patient group reported the highest level of pain intensity, the most employment disruption, and contained the highest percentage of patients receiving financial compensation, this same group paradoxically reported less emotional distress on the Symptom Checklist-90R than did LBP and HAP patients. This paradox may be due to the lesser chronicity of the RSD patients as well as to their apparently experiencing a more sympathetic response from doctors, employers, and insurance carriers than their LBP and HAP counterparts. On balance, the present data do not support the hypothesis the RSD patients, relative to other pain patients, are uniquely disturbed in psychosocial functioning.

Complex regional pain syndrome, alexithymia, and psychological distress

“…With regards to depression, higher [17,18], comparable [19,20], and lower [21,22] levels of depression have been found in persons with CRPS when compared to other groups. In a similar manner, findings on anxiety and CRPS diverge, with reports of higher [18], comparable [19], and lower [23] anxiety levels in persons with CRPS in comparison to other groups.…”

Psychische Veränderungen bei Patienten mit komplexem regionalem Schmerzsyndrom (CRPS)

“…Prä mor bid vor lie gen de psy chi sche Pro ble me oder Per sön lich keits auf fäl lig kei ten fan den sich in ver schie de nen, meist re trospek tiv und mit un ter schied li chen Me thoden durch ge führ ten Stu di en bei 37-60 der un ter such ten Pa ti en ten mit CRPS I [8,22,24,29].…”

“…Im Ver gleich mit an de ren Schmerz er kran kun gen (CRPS vs. Ra di ku lo pa thi en, Frak tur ohne Ent ste hung ei nes CRPS) zeig ten sich bei 2 Stu di en kei ne psy cho pa tho lo gi schen Unter schie de [9,16]. In ei ner wei te ren Studie (CRPS vs. Kopf schmer zen, chro ni sche Rücken schmer zen) fand sich in der Gruppe der CRPS-Pa ti en ten eher we ni ger emotio na ler Stress als bei den an de ren Gruppen [8].…”

Pain Ratings, Psychological Functioning and Quantitative EEG in a Controlled Study of Chronic Back Pain Patients

“…It is well known that chronic pain and especially chronic back pain is associated with psychological distress [17]–[19] in general and depression in particular [20]–[22]. This is most likely due to a self-maintaining process of pain and illness behaviour, less activity and social withdrawal which then results in psychological distress and has a negative effect on pain experience.…”