Anxiety increases pain intensity, disability

British researchers writing in The Journal of Pain , the peer-review publication of the American Pain Society, found that individuals with high levels of anxiety due to chronic pain exhibit more emotional distress and disability, but the use of pain coping strategies can mediate this effect.

The purpose of the study was to examine the role of anxiety on everyday functioning of patients seeking treatment for chronic pain. It was assumed anxiety would be associated with higher levels of distress and impaired functioning. The researchers also evaluated the role of three coping mechanisms to determine their impact as buffers nullifying the effects of anxiety. They are acceptance of pain, mindfulness and values-based action.

The study subjects were 125 consecutive adult patients who answered questionnaires designed to assess their anxiety about pain, measure their acceptance of it, identify the values they associated with interacting with family and friends and with working and learning, and to gauge the level of their mindfulness about pain ranging from almost always to almost never.

Results of the study showed that anxiety is associated with greater pain, emotional distress and disability in chronic pain patients. Anxiety was determined to be the strongest predictor of depression, disability and visits to physician offices. When the three coping strategies were used, the authors concluded that acceptance of pain, mindfulness and values-based actions reduce but do not eliminate the extent to which anxiety influences patient functioning. The authors concluded that in conjunction with cognitive-behavioral therapies, the coping mechanisms can undermine the role of anxiety in worsening suffering and disability in chronic pain patients.