New research presented at the EFIC ‘Pain in Europe VII’ Congress in Hamburg shows that traumatic experiences, such as war captivity and torture are directly associated with subsequent chronic pain and may inflict a long-term dysfunction of pain inhibitory pathways. A good medicine for victims proves to be education, talking and understanding.
35 years after the end of war and captivity torture still seems to linger on.
At the Congress, an Israeli team of researchers presented a study on pain perception and psychological status. They examined 60 former prisoners of war (POWs) and 40 controls, which all underwent testing procedures, including evaluation of heat pain-thresholds. By filling in a questionnaire, all participants reported their assessment of post-traumatic stress disorder, psychiatric symptomatology, and chronic pain.
Dr. Ruth Defrin from Tel-Aviv, Israel told the EFIC Congress. “The results were striking. The former POWs exhibited increased temporal summation of pain, decreased continuous pain modulation and greater magnitude of chronic pain in more body regions more than 35 years after their captivity. Furthermore, the former POWs exhibited higher levels of post-traumatic stress disorder, pain catastrophizing, and anxiety sensitivity.” She explained that chronic pain intensity was significantly connected to catastrophizing pain and anxiety sensitivity.
Earlier studies already indicated that both physical and psychological torture can provoke severe and chronic effects, including chronic pain, emotional suffering and mental-health problems.
Due to the rarity of comprehensive systematic longitudinal studies of the long-term multifaceted aftermath of war captivity and torture, the resulting long-term effects of psychological and physical pain were poorly understood until now.
Dr. Defrin concluded:
“Looking at the results of our study, it appears that war captivity and torture inflict a long-term dysfunction of pain inhibitory pathways. This dysfunction along with the emotional consequences might underlie the high rates of severe chronic pain among torture survivors.”
Pain program for torture survivors: education reduces suffering
According to Dr. Gunilla Brodda Jansen from Stockholm, Sweden:
“Many refugees who came to Sweden after having experienced torture developed pain and PTSD. There is a need for better understanding and treatment of those patients, who often are unrecognized in primary care and hospitals.”
In a recent study Jansen and her team examined ways to improve treatment options for torture survivors. They analyzed 32 Arabic speaking patients, 8 women and 24 men, mostly from Iraq, who had been suffering from long-standing pain. Participants were examined with their physical and mental health being assessed before they were included in a 10-week long pain management program consisting of one 2-hour session each week. The team of the pain management program included a physician, a psychologist, a nurse and a physiotherapist. Groups were mixed, i.e. male and female participants, with each group consisting of 8 to 10 patients. Both groups had the use of an Arabic speaking interpreter who translated the lecture and all were given ample time for questions. Participants received education on the physiological, psychological and on social aspects of pain, and discussed pain medication, stress, physical activity and cognitive aspects of pain.
Dr. Brodda Jansen said in a concluding statement:
“Torture survivors score very high regarding depression, anxiety, catastrophic thoughts, and they have low quality of life. Most participants (21) fulfilled criteria for fibromyalgia. The pain class was very much appreciated and reduced suffering. Anxiety decreased slightly, but not depression. In total, life satisfaction of our patients increased. Education, talking and understanding have shown to be a good medicine.”
About EFIC and “Pain in Europe”
Established in 1993, the European Federation of IASP® chapters (EFIC®) is a multidisciplinary professional organization in pain research and medicine. It consists of the 35 so-called chapters of the International Association for the Study of Pain (IASP®), which are the IASP approved official National Pain Societies in each country.
EFIC’s constituent chapters represent Pain Societies from 35 European countries including almost 20,000 physicians, basic researchers, nurses, physiotherapists, psychologists and other healthcare professionals across Europe, who are involved in pain management and pain research.
The Federation’s aims are to advance research, education, clinical management and professional practice related to pain, as well as to serve as an authoritative, scientifically based resource concerning policy issues related to pain management.
EFIC Congresses have become a popular forum in Europe attracting more than 4,000 participants in 2011, with this year’s “Pain in Europe VII” in Hamburg (21-24 September 2011) being the 7th EFIC Congress since 1995.
Congress participants are predominantly Europeans, however, with delegates from over 75 countries worldwide, the Congress can be considered to be the major international educational exchange on pain issues of this year 2011.
Written by: Petra Rattue