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The following is a summary of “Metaphorical markers of pain catastrophizing, depression, anxiety, and pain interference in people with chronic pain,” published in the November 2024 issue of Pain by Hearn et al. 

Metaphors used to describe chronic pain can reflect psychological perceptions of pain and its impact, potentially improving understanding of its causes and supporting shared decision-making.  

Researchers conducted a retrospective study to analyze the use of metaphors and relationships with pain intensity, interference, mood, and pain catastrophizing.  

They examined 70 participants with chronic pain who completed assessments for depression, anxiety, and stress, the Brief Pain Inventory, and the Pain Catastrophizing Scale. The participants were asked to describe the pain using metaphors and identify the primary condition associated with pain.  

The results showed that pain catastrophizing predicted the metaphor use frequency (R²=.07, F (1, 62) =4.55, P =.041). More frequent metaphor use correlated with catastrophizing (r=.29, P =.03), rumination (r=.26, P =.05), magnification (r=.28, P =.03), helplessness (r=.28, P =.04), depression (r=.30, P =.02), and pain interference (r=.30, P =.02). The metaphors of physical damage were associated with anxiety (OR 1.17, 95% CI 1.03-1.35, P =.02) and magnification (OR 1.27, 95% CI 1.05-1.57, P =.02) and the metaphors of external causation were associated with depression (OR 1.11, 95% CI 1.01-1.23, P =.04) and pain duration (OR 1.05, 95% CI 1.00-1.11, P =.04).  

They concluded that specific metaphors in patients with chronic pain may be associated with psychological and pain-related outcomes, highlighting the potential of metaphor-based interventions to improve patient-provider communication and support. 

Source: jpain.org/article/S1526-5900(24)00711-9/fulltext