Body awareness, stress and symptoms in autonomic dysfunction in patients with chronic pain: an explorative study

Emma Varkey; Raquel  Gottfridsson; Anna  Grimby-Ekman; Anna  Bjarnegård Sellius; Maria  Östman; Paulin  Andréll

doi:10.2340/jrmcc.v7.13374

Authors

Emma Varkey Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Occupational Therapy and Physiotherapy, Gothenburg, Sweden https://orcid.org/0000-0002-1035-2734
Raquel Gottfridsson Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Anaesthesiology and Intensive Care Medicine/Pain Centre, Gothenburg, Sweden
Anna Grimby-Ekman School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden https://orcid.org/0000-0002-9408-6065
Anna Bjarnegård Sellius Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Occupational Therapy and Physiotherapy, Gothenburg, Sweden
Maria Östman Region Västra Götaland, Närhälsan Gibraltar Rehabilitation Centre, Gothenburg, Sweden
Paulin Andréll Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburgh, Sweden; Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Anaesthesiology and Intensive Care Medicine/Pain Centre, Gothenburg, Sweden; Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden https://orcid.org/0000-0001-6941-6096

DOI:

https://doi.org/10.2340/jrmcc.v7.13374

Keywords:

autonomic dysfunction, body awareness, chronic pain, pain intensity, pain duration, stress level

Abstract

Objective: To assess pain outcomes, stress levels and body awareness among patients with chronic pain and explore potential associations between these variables.

Design: An explorative study.

Methods: Patients with chronic pain in primary and specialist care were assessed regarding pain intensity using the Numerical Rating Scale (NRS; 0–10 point scale) and stress levels using the Stress and Crisis Inventory (SCI-93; 0–140). To assess body awareness, multidimensional assessment of interoceptive awareness (MAIA; 0–5), a widely used self-report measure of interoceptive bodily awareness was used.

Results: Participants (n = 42) reported an average NRS of 4.4, elevated stress levels and low body awareness. Stress levels were moderately correlated with pain intensity (r = 0.53; p < 0.001; 95% confidence interval [CI] 0.25–0.72) and number of pain sites (r = 0.58; p < 0.001; 95% CI 0.32–0.76). The regression analysis showed that pain outcomes predicted stress level scores and explained almost 50% of variance (R²= 0.47, p < 0.001). Moreover, shorter pain duration predicted a higher body awareness (p = 0.04).

Conclusion: In patients with chronic pain, high pain intensity and multiple painful sites seem to be associated with impaired stress regulation. The patients had low body awareness, which was negatively influenced by pain duration.