Study found many overdo things resulted in significant pain flareups after. However, if they have periods where they avoid things that hurt, they are then categorized as avoidant – can’t seem to win though a paced life would be obvious.
Pain. 2015 Jun 9. [Epub ahead of print]
Overactivity in chronic pain: Is it a valid construct?
Andrews NE(1), Strong J, Meredith PJ.
http://www.ncbi.nlm.nih.gov/pubmed/26067583
- 68 patients – hand held computer diary
- Considered a pre-morbid (lifelong) habit of overdoing things and then needing to rest and avoid things that cause pain-creating a yo-yo effect.
- sustaining a certain posture in inactivity for over 2 hours was considered an issue
Patterns:
- High overactivity and high avoidance 20%
- high overactivity -low avoidance 30%
- low activity – high avoidance 31%
- low overactivity – low avoidance 19%
Study was smart enough to realize subjects with low activity- high avoidance were probably in more pain.
Comment – worst case of above was a lady with chronic pain who went hypomanic and painted her bedroom in one day. She then spent 2 days in bed admiring it…
Avoidance issues must take into account the issue that the pain might not be understood. When the Mc Gill Pain questionnaire came out, they cataloged Fibromyalgia as having pain up near childbirth. However, for years, this group suffered with various attitudes of them being lazy or crazy. Now with both inflammatory and small fiber neuropathy flavours becoming apparent, how hopefully this will change.
There are hence 2 issues that must be considered
- -what the problem is – unfortunate for issues like back pain where it can be severe enough to cause brain changes but not bad enough to necessarily be taken seriously.
- – how bad is the pain – people in severe pain are not avoidance they are suffering.
Example I like:
dry socket syndrome – not well understood but more painful then one would think. If one looks at it in a fear avoidant fashion, one should chew on that side…:)