October 11, 2010

Painful Emotion...Literally

Feeling hostile? Angry? Depressed? Your experience of physical pain is likely to be worse when you have these emotions.

Anger and sadness worsen pain. That's the conclusion of a team of researchers from Utrecht University, Holland.

The researchers had expected that negative emotions would increase pain more in the women with fibromyalgia. That's not what they saw.

The researchers studied 62 women who had fibromyalgia and 59 women who did not. Fibromyalgia is a condition that causes constant pain. Since the pain is constant, the researchers were able to directly test the effect of sadness and anger on that pain. For the other women in the study, pain was induced electrically: increasing the size of an electrical shock first caused a noticeable feeling, then pain, and finally, intolerable pain. As the electrical charge was increased, the women pushed different buttons to indicate when these levels had been reached.

Study participants were asked to recall neutral situations from their past, anger-causing situations and also those that had caused sadness. The effect of these memories on pain was then measured. For the women with fibromyalgia, this consisted of reporting their current pain level before and after recalling the emotion-inducing event. For the other women, this consisted of testing how painful the electric shocks were before and after the emotional recollections, as well as noting how much electricity was required for the shocks to become painful. Trials were repeated four times for each group.

In both groups of women, anger and sadness increased pain. In the women without fibromyalgia, anger and sadness also lowered the size of the smallest electrical shock that was painful.

The researchers had expected that negative emotions would increase pain more in the women with fibromyalgia. That's not what they saw. There was no indication that anger and sadness affected one group more than the other. Sadness and anger made pain more painful for everyone.

People with fibromyalgia hurt all over and frequently feel exhausted. They have multiple tender points on their body, where the slightest pressure causes additional pain. They awaken tired and get more exhausted as the day wears on. Simply making it through the day is a struggle. Anything that makes their life easier would be greatly appreciated. The researchers suggest that emotional regulation techniques may prove helpful, limiting the opportunity for anger and sadness to make a barely tolerable condition even worse.

For people who are fortunate enough to have only occasional pain, knowing that anger and sadness will only make the pain worse should be helpful, too. Forewarned is forearmed.

An article detailing the study appears in the October 2010 print issue of the journal Arthritis Care & Research.

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