Pain Site: How Much Does it Matter?

Abstract

The medical and lay attitudes toward site of pain impressed us as being paradoxical. Though commonly used as a basic means for classifying and characterizing pain, it is not always considered in research and little is known about its psychosocial and clinical aspects. Our purpose was to examine the demographic, clinical, psychiatric, emotional, and pain-descriptive correlates of pain site, specifically in the head, upper back, and low back. The subjects were eighty-four pain patients selected randomly from two pain clinics. They were administered questionnaires assessing demographic and clinical features, trait anxiety and anger (Spielberger's STPI), inhibited anger (Kreitler and Kreitler), psychiatric tendencies (BSI, Derogatis), alexithymia, and pain experience (McGill Pain Questionnaire and Meaning Pain Scale). The results were that the three groups of patients differed in a great number of correlates that enabled a significant discrimination between them, especially good between pain in the upper and lower body parts. The psychological profiles of the groups have implications for sickness behavior (highest for low back), susceptibility to pain distraction (highest for headache), and accessibility to psychological interventions (highest for upper back). Pain site was shown to be an important factor for characterizing pain and defining the limits of generalizations about chronic pain.