Researchers at Sechenov University discovered which individuals are more likely to experience acute pain transitioning into chronic pain.

The study was published in the journal "Neurological Bulletin." Any chronic pain, whether it be migraines or fibromyalgia (painful sensations in muscles, tendons, and joints), leads to similar changes in the brain, such as a reduction in gray matter density. The reasons that trigger the transition of acute pain to chronic, meaning daily pain, are varied. The extent to which certain factors affect an individual's condition is still not fully understood.

Scientists from the Department of Psychiatry and Psychosomatics at Sechenov University have for the first time analyzed the contributions of traumatic life events, mental disorders, and personal qualities of patients to the development of chronic pain. The three-year study was conducted at the A.Ya. Kozhevnikov Nervous Diseases Clinic, headed by Professor Vladimir Parfenov. It involved 105 patients aged 18 to 70 who were hospitalized to identify the cause of their persistent pain.

In nearly all cases, the onset of chronic pain was preceded by some kind of psychotraumatic event. The largest proportion of patients (26 percent) had lost loved ones, 20 percent had experienced illness, injury, or surgery, 15 percent faced the illness of relatives, 18 percent endured significant stress at work or school, 16 percent suffered physical, sexual, or psychological abuse, and three percent experienced complicated childbirth. Only seven percent of study participants were unable to identify any event that could have influenced their condition.

The research indicated that individuals reacted differently to traumatic events. Most patients began to experience chronic pain due to prolonged stress and emotional exhaustion, lasting on average 2.5 years. Contributing factors included physical illness, prolonged illness of loved ones, and high work demands.

“This reaction to prolonged stress, manifesting as chronic pain, was primarily observed in individuals prone to anxiety and neuroses. They were in a state close to anxiety or other disorders, even though their symptoms did not meet diagnostic criteria. In addition to pain, patients experienced feelings of helplessness, depression, sleep and appetite disturbances, dizziness, skin itching, and other symptoms,” explained one of the authors of the scientific article, Dmitry Petelin, an assistant at the Department of Psychiatry and Psychosomatics at Sechenov University.

In contrast, a strong and acute stressor, such as the death of a loved one, sudden job loss, or a violent attack, primarily affected individuals who had been depressed or in a low mood for an average of a year. According to Petelin, in such cases, less than a month passed from the psychotraumatic event caused by the tragedy to the development of chronic pain.

A very small number of patients, about seven percent, could not identify any psychotraumatic events that influenced their condition, even though they had been experiencing severe, unexplained pain for years. These individuals displayed emotional instability, impulsivity, and social withdrawal.

“From the data we obtained, we can conclude that stress plays a key role in the development of chronic pain for most patients. However, this effect varies depending on individual personality traits,” noted Beatrice Voilel, director of the N.V. Sklifosovsky Clinical Medicine Institute, professor at the Department of Psychiatry and Psychosomatics, and curator of the Psychosomatic Medicine Clinic at Sechenov University.

The Psychosomatic Medicine Clinic works with patients suffering from chronic pain, significantly alleviating their condition. The findings from this research allow for the exploration of new ways to prevent the transition of acute pain to chronic pain. Given the significant role of psychotraumatic events in the development and maintenance of chronic pain, various psychotherapeutic and rehabilitation techniques aimed at reducing stress levels may serve as preventive measures, the researchers noted.