Coping strategies in chronic migraine and chronic low back pain patients

Abstract

Chronic pain is frequently resistant to medication. Some studies confirm what coping strategies (CS) (constantly changing cognitive and behavioural efforts to manage stressful events) have impact on pain chronification and treatment efficiency. Some types of CS could have more influence on pain, demanding more attention during its management. The aim of this study was to detect the more influent CS in patients with chronic migraine (CM) and chronic low back pain (CLBP). The first group included forty patients with CM, 37 females, 3 males, mean age 42,83 ± 10,88 years. The comparison group included 50 patients with CLBP, 31 females, 19 males, mean age 49.24 ± 10.87 years. We performed Chronic Pain Coping Inventory, Chronic Pain Acceptance Questionnaire and Back Persistence Scale in both groups and compared the use of SC with chronic pain characteristics. Both groups used more frequently passive CS. In patients with CLBP (with similar pain intensity) CS as Task persistence were strongly negative correlated (discordant) with pain intensity (z = 2,34; p<0,01) and pain duration (z = -1,71; p<0,05). CS as Guarding were concordant with frequency of pain accesses (z = 2,34; p< 0,01) and disability (z = 1,89; p<0,05). In patients with CM (with similar pain intensity) CS as Resting were strongly positive correlated (concordant) with pain duration (z = 1,67, p<0,05) and with reduced pain treatment response (z = 1,73; p<0,05). The study results confirm the impact of CS on pain evolution, the passive ones being more dysadaptive. The most influent CS in CLBP patients were Guarding and Task persistence, and in CM patients - Resting.