Thread by @JillPiggott

.@BethDarnall designed the questionnaire widely used to diagnose Pain Catastrophizing (PC). She pinned a survey to her twitter pg, asking people in #ChronicPain what they think of the term. Research on PC & rx #opioids is +75 times higher now than in '00-02.

What's PC? / thread

https://twitter.com/JillPiggott/status/1279790434986967041

The Pain Catastrophizing Scale measures "rumination (eg, 'I can't stop thinking about how much it hurts'), magnification (eg, 'I worry that something serious may happen'), and helplessness (eg, There is nothing I can do to reduce the intensity of the pain')." [Darnall note 1]

"Psycho-pathology is both an antecedent & a consequence of persistent pain." [note 2]

Pain catastrophizing is "a mental set related to pain that is characterized by feelings of helplessness and persistent and unrealistic beliefs about pain and its consequences." [note 3]

"[P]atients who evince a greater tendency toward pain catastrophizing ... are vulnerable to misuse of #opioids." [note 2]

🚩Providers should inform patients that "Pain Catastrophizing" scores are used to assess anxiety AND risk of #opioid-misuse.

I told my research #neurologist about catastrophizing. He said, "Yeah, no, that's what they used to think in the 50s."

Psychologists & neurologists look at the same brain imaging studies & reach dramatically different conclusions. @headsUPmigraine plays for Team Neurology.

Speaking of the 1950s: "research has suggested females may engage in pain behavior for extended periods of time and may appraise their pain as more threatening than males." [note 4]

#Migraine misdiagnosed as can disable. It's a progressive brain disease. People can go from 1 migraine monthly to continuous migraine in 1 year. Ineffective treatment of low-frequency monthly migraine doubles the risk of continuous migraine.

Note 1: Darnall BD, Sturgeon JA, Cook KF, Taub CJ, Roy A, Burns JW, Sullivan M, Mackey SC. Development and validation of a daily pain catastrophizing scale. The Journal of Pain. 2017 Sep 1;18(9):1139-49.
ncbi.nlm.nih.gov/pmc/articles/P…

Note 2: Hah JM, Sturgeon JA, Zocca J, Sharifzadeh Y, Mackey SC. Factors associated with prescription opioid misuse in a cross-sectional cohort of patients with chronic non-cancer pain. Journal of pain research. 2017;10:979.
ncbi.nlm.nih.gov/pmc/articles/P…

Note 3: Darnall BD, Colloca L. Optimizing placebo and minimizing nocebo to reduce pain, catastrophizing, and opioid use: International review of neurobiology 2018 Jan 1 (Vol. 139, pp. 129-157). ncbi.nlm.nih.gov/pmc/articles/P…

Sharifzadeh Y, Kao MC, Sturgeon JA, Rico TJ, Mackey S, Darnall BD. Pain catastrophizing moderates relationships between pain intensity and opioid prescription. Anesthesiology. 2017 Jul 1;127(1):136-46. anesthesiology.pubs.asahq.org/article.aspx?a…

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