Background & Aims
Chronic neck pain has a significant impact on physical and psychological well-being (1). Cognitive and emotional factors play a critical role in individuals with chronic musculoskeletal disease . This includes attention, pain perception, modulation, critical thinking, and pain relief, as many brain regions involved in pain processing also play roles in cognitive tasks (2). Understanding this relationship is essential for a comprehensive approach to managing chronic musculoskeletal pain (3). This study aims to investigate the correlation between pain and functional levels with decision-making and critical thinking in patients with chronic neck pain.
Methods
Sixty-two chronic neck pain patients (44 female, 18 male, age: 50.82 ± 10.79 years, weight: 72.33 ± 11.52 kg, height: 168.09 ± 8.03 cm), seeking care for at least 3 months, were included. Visual analogue scale for rest, night and activity pain, Pain Catastrophizing Scale, Neck Disability Index, Melbourne Decision-Making Scale, and Marmara Critical Thinking Inventory were used for assessments.
Results
Negative correlations were found between resting pain and Marmara Critical Thinking Inventory subgroups (reasoning, arriving at judgment, searching for evidence, searching for truth, open-mindedness) (rho=-0.395, p=0.002). Negative correlations also emerged between pain during activity and careful decision-making style, and Marmara Critical Thinking Inventory sub-groups (reasoning, arriving at judgment, evidence-searching, truth-searching, open-mindedness, systematicity) (p<0.05). Night pain exhibited negative correlations with the sub-parameters of the Melbourne Decision-Making Scale, Self-Esteem in Decision Making and Careful Decision-Making Style, and the total score of the questionnaire (rho=-0.312, p=0.013). Functional level displayed negative correlations with sub-parameters of the Melbourne Decision-Making Scale, Self-Esteem in Decision Making and Careful Decision-Making Style and a negative relationship in all parameters of the Marmara Critical Thinking Inventory (p<0.05).
Conclusions
The study highlights a significant relationship between chronic neck pain, psychological factors, and cognitive processes. Decision-making demonstrated a low negative correlation with pain and function, while critical thinking showed a low to moderate negative correlation. These findings provide crucial insights into the complex interplay between chronic pain and psychological and cognitive factors, informing potential interventions to improve patient outcomes.
References
1- Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26. doi: 10.1186/s12891-021-04957-4. PMID: 34980079; PMCID: PMC8725362.
2 – Timm A, Schmidt-Wilcke T, Blenk S, Studer B. Altered social decision making in patients with chronic pain. Psychol Med. 2023 Apr;53(6):2466-2475. doi: 10.1017/S0033291721004359. Epub 2021 Nov 5. PMID: 34736548; PMCID: PMC10123842.
3- Peters ML. Emotional and Cognitive Influences on Pain Experience. Mod Trends Pharmacopsychiatry. 2015;30:138-52. doi: 10.1159/000435938. Epub 2015 Sep 18. PMID: 26436897.