Focusing on ‘pain catastrophizing’ could help service members stay on active duty 

Pain catastrophizing — having persistent, distressing thoughts and feelings about your pain — is known to make it harder for people with chronic pain to function. For military personnel, this relationship can be particularly detrimental for fulfilling their service duties.

A new study, conducted in part by researchers at the University of Illinois Chicago, looked at pain catastrophizing in that population for the first time and found that high levels made it more likely that service members would later go on medical disability. However, when treatment helped lower a person’s level of pain catastrophizing, their likelihood of medical disability was lowered, too. The findings point to a potential way to keep military personnel on active duty.

“Addressing pain catastrophizing is important in supporting the ability of active-duty service members’ to perform successfully,” said UIC nursing professor Ardith Doorenbos, who is the senior author on the paper. 

The study looked at data from active-duty service members referred to the Madigan Army Medical Center Interdisciplinary Pain Management Center who filled out an established pain catastrophizing scale during a two-year period between 2018-2020. The researchers analyzed if individuals’ score on the scale changed later and whether they were put on medical disability within the next year. 

The researchers found that those who scored above 20 on the 53-point scale were more likely to go on disability. They also found that if someone initially scored high on the scale, but that number came down during treatment, they were significantly less likely to go on disability later. 

That second finding points to an important focus for treatment.

“Pain catastrophizing is modifiable,” the authors write. “Identifying this high-risk population earlier in the course of their pain care may help with planning early interventions that may change the disability trajectory.”

For example, cognitive behavioral therapy has been shown to reduce levels of pain catastrophizing, and the researchers encourage the military to offer it to service members with high levels of catastrophizing. 

The research was published recently in the Journal of Pain Research. Coauthors include UIC College of Nursing research associate professor Alana Steffen, Sherrill Schaaf at A.T. Still University and Diane Flynn and Jeffrey Ransom at the Madigan Army Medical Center.