Clinical correlates of pain variability in chronic pain

Given the multidimensional nature of chronic pain, some variability in pain reports is expected; however, a subset of chronic pain patients report persistently high levels of pain with little variability. Such reports may be influenced by psychological factors and may be relevant in the assessment and treatment of chronic pain. The authors assessed the relationship between pain variability and a variety of clinical variables using the archival records of an interdisciplinary chronic pain rehabilitation program. It was found that patients who report high levels of pain with little or no variability are more likely (a) to drop out of a rehabilitation program, (b) to catastrophize in response to pain, (c) to report more pain-related conflict with spouses, and (d) to rate their pain as severe. These results suggest that assessment of pain variability has some predictive utility and that such variability warrants further study using multidimensional measures of pain.