UF Researchers Describe Link Between Chronic Pain And Depression

August 30, 1996

UF researchers describe link between chronic pain and depressionUF researchers describe link between chronic pain and depression

By Melanie Fridl Ross

GAINESVILLE, Fla.---Athletes thrive on pushing themselves to limit, training to the mantra, "no pain, no gain."

But for thousands of people pain is not positive. It is a keen reminder of an injury or illness that can lead to mental suffering equally disabling.

"Pain itself and the ensuing disruption in normal lifestyle can lead to depression," says Dr. Michael E. Robinson, associate professor of clinical and health psychology at UF's College of Health Professions. "Patients feel helpless and hopeless. This makes their pain more intense."

In fact, the emotional effects of chronic pain -- including depression, anger and anxiety -- may do more damage to long-term health than the actual physical degree of discomfort, report University of Florida researchers in recent issues of the journals Cranio and The Clinical Journal of Pain.

In studies of nearly 200 patients with chronic facial pain caused by temporomandibular disorders (TMD) -- problems that encompass structures or systems involved with jaw movement, including the muscles or jaw joints and the ligaments and tendons attached to them -- UF researchers found that psychological effects of being in pain were more disruptive to patients' daily lives than the pain itself.

"Pain is a complex phenomenon that involves both emotional and physical components," said Robinson, who collaborated with researchers from UF's College of Dentistry. "Pain has a direct relationship to tissue damage, but it is subject to influence by a patient's emotional state, by previous experience with painful conditions and by the meaning ascribed to the sensation."

The patients, who sought treatment through the college of dentistry's Parker E. Mahan Facial Pain Center, reported routine tasks had become daily hassles -- from speaking on the telephone or eating to taking medications and carrying on a conversation.

"Communication with the world around you becomes stressful because it hurts," Robinson said. "These incidents may seem small in isolation, but the constant needling can become a major life problem. "The patient who believes their pain signals some life-threatening illness will feel that same sensation as much more painful than a different person with the same tissue damage who feels that they've simply pulled a muscle," he added.

Nearly 80 percent of the U.S. population reports some TMD symptoms, according to the Lafayette, Calif.-based American Academy of Orofacial Pain. Chronic pain in general accounts for up to $90 billion annually in direct or indirect health-care costs or loss of productivity due to work absences, said Dr. Henry Gremillion, director of the Facial Pain Center.

"That's staggering," he said. "Chronic pain is certainly a costly problem, physically, financially and emotionally. Statistics indicate that the head, face and neck region is the most common site of chronic pain expression.

"It is important that the public understand that pain is a complex disorder with many facets," Gremillion said. "And the best way to diagnose and manage pain is through a team approach involving health care professionals of various disciplines who can look at the patient's condition from several different perspectives."

University of Florida

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