Anger & Chronic Back Pain

Reference:Scott W, et al Anger differentially mediates the relationship between perceived injustice and chronic pain outcomes. Pain. 2013 Sep;154(9):1691-8.

A number of studies suggest that perceived injustice is a risk factor for the development of chronic pain.

Questions: What mediates the relationship between perceived injustice and persistent pain?

In this study, 173 individuals with chronic low back pain and/or fibromyalgia completed various self-report measures. Consistent with previous studies, a high score on perceived injustice was associated with greater pain, depression, and disability.

However this study showed for the first time that ANGER intensity and anger suppression (the tendency keep anger “bottled up”) mediated the relationship between perceived injustice, pain intensity, and depressive symptoms.

Although speculative, anger management interventions such as validating patients’ pain and suffering may help reduce the negative impacts of perceived injustice.

I wish I could somehow help my patients fully resolve their anger issues, but I’m just a physio and dealing with those issues is often well beyond my capability and scope of practice.

Clinical Relevance: What is important is that you recognize that perceived injustice and anger are major factors in chronic low back pain.

We can let them vent out their anger but patients ultimately must accept that their anger is a potential contributing factor to their pain and disability.

They need to either deal with it and get over it or seek professional help.

Posted on: March 10, 2014

Categories: Lumbar Spine , Fascinating Pain Studies

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