Association of catastrophizing with interleukin-6 responses to acute pain

Abstract

Catastrophizing exerts its deleterious effects on pain via multiple pathways, and some researchers have reported that high levels of catastrophizing are associated with enhanced physiological reactivity to painful stimulation. In this project, 42 generally healthy adults underwent a series of psychophysical pain testing procedures assessing responses to noxious mechanical, heat, and cold stimuli. Pain-catastrophizing cognitions were assessed prior to and then immediately after the various pain induction procedures. Blood samples were taken at baseline and then at several time points from the end of the procedures to 1 hour post-testing. Samples were assayed for serum levels of cortisol and interleukin-6 (IL-6). Both cortisol and IL-6 increased from baseline during the post-testing period (p's< .05), with cortisol returning to baseline by 1 hour post-testing and IL-6 remaining elevated. Pain catastrophizing, measured immediately after the pain procedures, was unrelated to cortisol reactivity, but was strongly related to IL-6 reactivity (p< .01), with higher levels of catastrophizing predicting greater IL-6 reactivity. In multivariate analyses, the relationship between catastrophizing and IL-6 reactivity was independent of pain ratings. Collectively, these findings suggest that cognitive and emotional responses during the experience of pain can shape pro-inflammatory immune system responses to noxious stimulation. This pathway may represent one important mechanism by which catastrophizing and other psychosocial factors shape the experience of both acute and chronic pain in a variety of settings.

Systemic inflammatory profiles and their relationships with demographic, behavioural and clinical features in acute low back pain

“…enhanced/suppressed production of multiple cytokines) [120]. Demographic [99], physical [94,102] and psychosocial [25,28,31,70] factors can also shape cytokine/CRP profiles, independent of tissue injury (see below). Together these variations could limit identification of changes in specific cytokines, but still be detectable using robust generic markers of inflammation such as CRP [82].…”

“…Associations between inflammation, sleep loss and psychological symptoms are well documented in a variety of conditions [14,27,28,31,38,46,70]. Although the interrelationships are not fully understood, abnormal hypothalamic-pituitary adrenal-axis (HPA-axis) function has emerged as a possible explanation [27].…”

Guided Imagery for Total Knee Replacement: A Randomized, Placebo-Controlled Pilot Study

“…46 Catastrophizing is a cognitive and affective orientation to pain that has a negative influence on pain-related outcomes. [50][51][52] In one recent investigation of 140 patients undergoing TKR, pain catastrophizing was the sole predictor of poor TKR outcome. 53 Catastrophizing may increase macrophage activation and thus inflammation, as suggested by a study of laboratory-induced pain in 42 healthy volunteers.…”

“…53 Catastrophizing may increase macrophage activation and thus inflammation, as suggested by a study of laboratory-induced pain in 42 healthy volunteers. 51 The fear-avoidance model of pain posits that catastrophizing leads to fear of movement (kinesophobia), 54 which may lead to avoidant coping 49 and negatively affect functional status and quality of life after TKR through reduced commitment to postoperative rehabilitation participation. 55 Incorporating imagery exercises in athletic training and stroke rehabilitation improves performance and recovery.…”

Neck Pain: Much More Than a Psychosocial Condition

“…It has been shown that high levels of posttraumatic stress symptomatology are more strongly associated with less daily activity (measured using ambulatory data collection methods) than high fear-avoidance beliefs, 20 and that catastrophizing is strongly related to levels of inflammatory biomarkers (IL-6) in induced acute pain. 3 There is still much to be learned about the nexus between physical (sensory and motor) manifestations and psychological aspects of neck pain. For practitioners, it is also important to realize the potential influence of psychological factors on the patient's physical presentation and vice versa.…”