The Relationship Between Guarding, Pain, and Emotion

Overview

Journal Pain Rep

Publisher Wolters Kluwer

Date 2019 Oct 4

PMID 31579861

Citations 8

Authors

Temitayo Olugbade

Nadia Bianchi-Berthouze

Amanda C de C Williams

Affiliations

Soon will be listed here.

Abstract

Introduction: Pain-related behavior in people with chronic pain is often overlooked in a focus on increasing the amount of activity, yet it may limit activity and maintain pain and disability. Targeting it in treatment requires better understanding of the role of beliefs, emotion, and pain in pain behavior.

Objectives: This study aimed to clarify the interrelationships between guarding, pain, anxiety, and confidence in movement in people with chronic pain in everyday movements.

Methods: Physiotherapists rated extent of guarding on videos of people with chronic pain and healthy controls making specific movements. Bayesian modelling was used to determine how guarding was related to self-reported pain intensity, anxiety, and emotional distress, and observer-rated confidence in movement.

Results: The absence of guarding was associated with low levels of pain, anxiety, distress, and higher movement self-efficacy, but guarding behavior occurred at high and low levels of each of those variables. Guarding was not directly dependent on pain but on anxiety; the relationship between pain and guarding was mediated by anxiety, with a high probability. Nor was guarding directly related to the broader distress score, but to self-efficacy for movement, again with a high probability.

Conclusion: Pain-related guarding is more likely to be effectively addressed by intervention to reduce anxiety rather than pain (such as analgesia); more attention to people move with chronic pain, rather than only they move, is likely to help to extend activity.

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