Grant: Project Grant

One in five Canadian suffers from chronic pain. Psychological factors play an important role in the perception, development and maintenance of chronic pain. These factors however are often examined without considering the nature of the pain experience that could influence these psychological responses. In fact, someone experiencing pain that frequently shoots up to an intensity of 10/10 without any warnings (unpredictable) or ability to decrease its intensity (low control) might perceive this pain as more stressful compared to someone whose pain intensity is relatively stable even if on average both individuals' pain are of a similar intensity. From the general litterature, 4 characteristics of situations lead to a physiological stress response: Novelty, Unpredictability, Threat to ego, and Sense of low control (N.U.T.S.). The objective of this study is to examine the N.U.T.S. characteristics of pain-related and unrelated stressors, combined with individuals' vulnerability to these different characteristics and their associations with pain outcomes such as appraisal, interference, and disability. The study will recruit 300 patients with chronic low back pain from a provincial cohort of back pain patients. Participants will be asked to complete questionnaires at baseline and then fill out an electronic diary daily for 7 days and provide saliva samples to analyse basal cortisol levels. Finally, they will complete follow-up questionnaires 4-8 weeks later. A subgroup of patients will also be asked to participate in an individual interview to explore their experience of the stressful characteristics of pain. Study results will identify important dimensions of the stress experience that have been so far studied in isolation in the field of pain. Such knowledge could help improve the evaluation of pain and the treatment approaches that are proposed to patients. This study may thus potentially change the way we assess patients' psychological response to pain.