A word on disability. One might think that pain level is the major predictor of disability. It has been shown, in well-done studies, that other factors probably are more important. Catastrophizing, such as thinking one’s headache is always a 14 on a scale of 1 to 10, is one of these factors. Part of the pain practitioner’s job is to turn down the volume and limit the drama. We can talk to people about catastrophizing and try to reduce the fear that underlies it.

Catastrophizing by proxy also happens, such as when a parent thinks his child has the worst headaches on the planet. Fear of pain also plays a role in disability. Some people have more fear and anticipation of pain than others and, as with catastrophizing, fear of pain may be lessened through psychotherapy.

Dr. Lawrence Robbins
Practical Pain Management
March, 2015

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