Catastrophization

Why is it important to understand catastrophization in persistent pain?

It is normal for human beings to catastrophize from time to time. Catastrophizing is a way of thinking called “cognitive distortion” where, when an event occurs, we think the worst possible thing is going to happen with an overwhelming feeling of not being able to cope with that event. Learning how to reduce catastrophizing will help you regain a better quality of life when it comes to helping you manage your persistent pain symptoms.

Pain Related Catastrophization:

• Describes a problematic coping style when reacting to a painful experience.
• It is the tendency to magnify or exaggerate the threat value or seriousness of pain sensations.
• It emphasizes pain-related worry and fear, coupled with an inability to draw your attention away from your pain.

Three Main Characteristics of Catastrophizing Pain:

Magnification

• I wonder whether something serious may happen.
• I become afraid that the pain will get worse.
• I keep thinking of other painful events.

Rumination

• I anxiously want the pain to go away.
• I can’t seem to get it out of my mind.
• I keep thinking about how much it hurts.
• I keep thinking about how badly I want the pain to stop.

Helplessness

• I feel I can’t go on.
• I feel I can’t stand it anymore.
• There’s nothing I can do to reduce the intensity of the pain.
• It’s terrible and I think it’s never going to get any better.
• I worry all the time about whether it will end.
• It’s awful and I feel that the pain overwhelms me.

What Are the Effects of Catastrophization in our Body?

A study was done on patients to see what the effects of catastrophizing thoughts would do to a group of healthy adults when they underwent testing to painful heat and cold pressure.

What the researchers found when looking at their blood samples and catastrophization scores before, during, and after testing:

• They were looking at levels of cortisol (a stress hormone) and interleukin-6 (an inflammatory marker).
• Both levels of cortisol and IL-6 were increased post-testing.
• Cortisol levels normalized after one hour but IL-6 remained high.
• Patients that scored higher for catastrophization had higher levels of IL-6. This was not related to higher levels of pain.
• This means that the higher levels of IL-6 were not caused by higher pain levels felt during testing but, in fact, was due to their high catastrophization scores.

So, What Does This All Mean?

Many research studies have shown that catastrophization is linked strongly to the development of persistent pain. Our thoughts and beliefs are strongly linked with the likelihood that our pain will become chronic, even though the tissues have healed. Our coping and emotional styles during a painful event can create an increased inflammatory response in our body. Therefore, catastrophization needs to be identified early to minimize the chance of injuries and/or physical problems becoming chronic, or persistent.

Pain education is a very effective tool in helping patients who tend to catastrophize to understand what is happening in their bodies and why these things are happening. Pain Education helps to eliminate the threats of ongoing danger messages that are perceived by the brain.