Causes of and Treatment for Pain Catastrophizing


“Our data suggest that it may affect 5 to 10% of people with chronic pain. But we don’t have one set of accepted criteria to diagnose it. Different people use different questionnaires. There are also so many variables that contribute to it. It may be more common in people with insomnia, but we know that insomnia also causes increased pain sensitivity,” said Campbell. 

The Causes and Consequences of Pain Catastrophizing

The short answer is we don’t know the cause, and certainly multiple factors contribute.1

“Physiologic components may include inflammation and inflammatory mediators like cortisol. Functional MRI studies tell us that catastrophizers have increased activity in parts of the brain that are responsible for anticipation and emotion,” said Campbell.

“There may also be a genetic component. Pain catastrophizing may run in families. But is that genes or learned behavior? A person who catastrophizes pain may have a parent or spouse that also catastrophizes pain. It may be a family or cultural coping style,” added George.

The consequences of pain catastrophizing are better known than the cause. Catastrophizing has been associated with increased severity of acute and chronic pain, more postoperative pain, longer recovery, exaggerated usage of the healthcare system, increased disability, and a destructive influence on a person’s support network.1

Risk factors for pain catastrophizing need further research. The only risk factor that consistently shows up in studies is being female. Some studies show that age is a risk factor and some don’t.1

“We see poor outcomes in general,” said Campbell. “We also see more depression. Depression and pain catastrophizing seem to be bidirectional.” 

Treatment for Pain Catastrophizing

A recent placebo-controlled study, published in the journal Anesthesiology, looked at the possible usefulness of prescribing a selective serotonin reuptake inhibitor (SSRI) to treat pain catastrophizing after surgery. The researchers hypothesized that if pain catastrophizing has a physiologic basis, then downregulating serotonin pain receptors might help.2

This article originally appeared on Clinical Pain Advisor