Pain Behavior Predicts Chronic Pain Status

Most people don't suffer pain in silence. Pain behaviors are usually easy to spot. Besides the obvious moaning and groaning along with verbal complaints, there are nonverbal pain behaviors. For example, making faces, grimacing, rubbing the painful area, and guarding are common pain behaviors.

Guarding is defined as any behavior that prevents or reduces pain. Guarding behavior may include stiffness, limping, bracing a body part, and flinching. In this study, researchers found that guarding behavior may be a key component in pain assessment.

The data used came from the study of 148 workers with back pain. All workers had a recent back injury and were on workers compensation. Most of the men were construction workers. The women came from jobs in the health-care setting.

Each patient was given at least five different tests. The tests measured a wide range of items. Mental and physical health, fitness, disability, pain, and quality of life were just a few of the variables tested.

The results suggest that patients with guarding behavior are less likely to return to work after an episode of back pain. Guarding may be a sign that acute pain will become chronic pain. This is called a predictive factor. Higher levels of guarding behaviors were linked with more days missed at work.


Kenneth M. Prkachin, PhD, et al. Pain Behavior and the Development of Pain-Related Disability: The Importance of Guarding. In The Clinical Journal of Pain. March/April 2007. Vol. 23. No. 3. Pp. 270-277.


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