Examples of several pain diaries. Credit: Faculty of Medicine & Dentistry, University of Alberta
For some people suffering from chronic pain, part of their daily routine is recording the extent of it in a pain diary. Often done at the request of their physician or therapist, patients may be asked to record how severe the pain is, how it affects daily activities and which treatments ease it or make it worse.
The purpose of a pain diary is to capture important, often overlooked details a doctor might find helpful. But a new study from the University of Alberta's Faculty of Medicine & Dentistry shows those well-intentioned diaries may have unintended consequences.
The study, published in the January edition of the journal Rheumatology International, examined the effect of a daily pain diary on recovery from acute lower back sprain. Fifty-eight patients with lower back or lumbar sprains were recruited, all in their early 30s. Half the subjects were asked to keep a pain diary for four weeks and given instructions to rate their daily pain on a scale of one to ten. The other half acted as a control group and did not keep diaries.
The level of disability was the same in both groups at the start of the study. After three months, subjects underwent a follow-up assessment and were asked if they had recovered from their injuries. A stark difference was noted among the patients.
"What we found is that the group who kept the pain diary—even though we didn't ask them to keep an extensive diary, and even though many of them didn't keep a complete diary—had a much worse outcome," says Robert Ferrari, a clinical professor in the Faculty of Medicine & Dentistry's Department of Medicine and a practicing physician in several Edmonton medical clinics. "The self-reported recovery rates were 52 per cent in the group that kept a pain diary and 79 per cent recovery at three months in the group that did not keep a pain diary.
"That's a fairly profound effect. There aren't many things we do to patients in terms of treatment that affect the recovery for a group by 25 per cent."
Ferrari believes the findings are a clear indication that asking patients to focus too much on symptoms may cause them to amplify them, creating a perception of illness and in turn preventing recovery. In light of the findings he recommends physicians and therapists not ask their patients to keep pain diaries.
"It's just more evidence suggesting that how we think about our symptoms affects our symptoms. Symptoms are everything when it comes to the sense of recovery."
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Examples of several pain diaries. Credit: Faculty of Medicine & Dentistry, University of Alberta
For some people suffering from chronic pain, part of their daily routine is recording the extent of it in a pain diary. Often done at the request of their physician or therapist, patients may be asked to record how severe the pain is, how it affects daily activities and which treatments ease it or make it worse.
The purpose of a pain diary is to capture important, often overlooked details a doctor might find helpful. But a new study from the University of Alberta's Faculty of Medicine & Dentistry shows those well-intentioned diaries may have unintended consequences.
The study, published in the January edition of the journal Rheumatology International, examined the effect of a daily pain diary on recovery from acute lower back sprain. Fifty-eight patients with lower back or lumbar sprains were recruited, all in their early 30s. Half the subjects were asked to keep a pain diary for four weeks and given instructions to rate their daily pain on a scale of one to ten. The other half acted as a control group and did not keep diaries.
The level of disability was the same in both groups at the start of the study. After three months, subjects underwent a follow-up assessment and were asked if they had recovered from their injuries. A stark difference was noted among the patients.
"What we found is that the group who kept the pain diary—even though we didn't ask them to keep an extensive diary, and even though many of them didn't keep a complete diary—had a much worse outcome," says Robert Ferrari, a clinical professor in the Faculty of Medicine & Dentistry's Department of Medicine and a practicing physician in several Edmonton medical clinics. "The self-reported recovery rates were 52 per cent in the group that kept a pain diary and 79 per cent recovery at three months in the group that did not keep a pain diary.
"That's a fairly profound effect. There aren't many things we do to patients in terms of treatment that affect the recovery for a group by 25 per cent."
Ferrari believes the findings are a clear indication that asking patients to focus too much on symptoms may cause them to amplify them, creating a perception of illness and in turn preventing recovery. In light of the findings he recommends physicians and therapists not ask their patients to keep pain diaries.
"It's just more evidence suggesting that how we think about our symptoms affects our symptoms. Symptoms are everything when it comes to the sense of recovery."
Explore further: Pre-op back pain, pain sensitivity predict outcomes
Medical Xpress on facebook
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Pre-op back pain, pain sensitivity predict outcomes
(HealthDay)—Preoperative back pain and individual pain sensitivity can predict postoperative pain following lumbar surgery, according to a study published in the December issue of Pain Medicine.
Light therapy seems promising for nonspecific back pain
(HealthDay)—For adults with chronic nonspecific back pain (CNBP), light therapy is associated with reduction in pain intensity and improvement in depressive symptoms, according to a study published in the ...
Back pain? Move, don't rest!
Move if you have back pain, this is the advice of a researcher at the Sahlgrenska Academy, University of Gothenburg. Patients with acute low back pain who were advised to stay active despite the pain fared better than those ...
One in 3 women could potentially be spared chronic pain after breast cancer surgery
One in every three women undergoing a mastectomy could potentially be spared chronic post-operative pain if anesthesiologists used a regional anesthetic technique in combination with standard care, according to a new study.
Most patients with chronic kidney disease may experience long-term pain
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Long-term effect of deep brain stimulation on pain in patients with Parkinson's disease
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