Effects of symbolic function in pain experience and vocational outcome in chronic neck pain patients

Background & Aims

The aim of this study was to examine the relationship between symbolic function, coping, pain and long-term outcome in patients with chronic cervical pain.

Methods

The study population consisted of 104 subjects who could be candidates for cervical spine surgery for their pain at the Department of Neurosurgery. We followed patients 2 and 6 years after focusing on pain experience, vocational outcome and sick leave.

Results

Twenty-eight percent of patients were found to have poor symbolic function (primary alexithymia), using SAT9-test. The group classified having poor symbolic function reported use of more coping strategies and coping resources, but had a more external locus of control. They showed less objective neurophysiological findings, but rated more pain on the VAS-scale. The group with poor symbolic function had more sick-leave days 2 years after consultation and vocational outcome was very poor for persons with impaired symbolic function at 6-years follow-up. There was no significant improvements in pain experience after six years for the whole patients group with cervical pain undergoing evaluation and surgical treatment at the unit. At 6-year follow up patients with poor symbolic function still experienced higher pain levels than patients with good or moderately impaired symbolic function.

Conclusions

Our results indicate that pain can serve as an expression of distress or discomfort and expression of pain can be a way for individuals to communicate their need for rest, recovery or relief from stressors. In this context, taking sick leave becomes a symbolic action addressing broader well-being concerns. Understanding the symbolic function on stress and pain concerns can be valuable for health professionals and for individuals themselves. Encouraging open communication, recognizing and reorganizing the symbolic nature of stress can contribute to a more compassionate understanding of stress-related challenges and pain.

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Presenting Author

Hannu Hekkilä

Poster Authors

Hannu Heikkilä

Satasairaala

Lead Author

E-mail

Topics

Specific Pain Conditions/Pain in Specific Populations: Neck Pain