Healthbeat Report: Partners and Pain

November 3, 2011 8:36:17 PM PDT
Relationships are complex and so is chronic pain. It's long been known that spouses can influence pain. Tension and disagreements will make anyone uncomfortable. But everyday tension may affect a hurting back more than patients and their partners realize, according to some Chicago researchers.

Pauline Grabarke and her husband Eddie have been together going on 11 years. Like all couples, they have their ups and downs.

"We are always together," said Pauline.

A good part of their struggles revolve around Pauline's nearly constant suffering from low back pain caused by degenerative disc disease.

"I know what is going to hurt me so I avoid it," said Pauline.

The couple admits it impacts just about everything in their daily life.

"I care about my wife immensely, but there are times I am angry about the situation, frustrated about the situation," said Eddie.

Eddie knows his emotional support is crucial, but it's only natural that over time a partner's patience can wear thin. And this is where psychiatric researchers at Rush University Medical Center come in.

"When you are yelling at each other and criticizing and hostile of course everyone feels bad. But when does it affect pain? We do not know that," said John Burns, PhD, Clinical Psychologist, Rush University Medical Center.

Through an unusual study funded by the National Institutes of Health, researchers want to figure out if tense interaction between spouse and patient may be adding to back pain. They carefully watch what happens when couples have heated exchanges. Everything from muscle tension to blood pressure to facial expressions and voice are recorded. The couple is prompted to begin a conversation on a prickly subject.

Here is one of the Grabareks' recorded exchanges. Eddie asks Pauline about trying to exercise more: "I am not going to go try and think I can do all of these exercises and think I know what I am doing cause I could do more damage." She seems to get defensive. The monitors pick up her visual and physical response. A spouse may think they're being encouraging, but the patient may only hear criticism. Eddie suggests they try things outside their normal routine. "Our normal routine is my back is screwed up and we can't go out and do stuff," says Pauline.

After several minutes of tense talk, the patient then does simple exercises. The research team watches for signs of increased pain.

"It's too early to know but the preliminary findings we have support at least one hypotheses that criticism equals pain," said Dr. Burns.

If so, this seemingly normal dynamic may have a more profound effect on the healing process. Studying this could change the way we look at pain treatments and therapies.

"We need to provide coping strategies or coping tools for the patient the patient with the chronic pain and also provide coping tools for the significant other," said Dr. Asokumar Buvanendran, anesthesiologist, Rush University Medical Center.

Counseling to promote better communication is one of those tools.

"So everybody would be thinking about the pain differently and working and communicating about it differently," Dr. Burns.

"Although my stress level is starting to build, I can see what she is enduring and I am able to pull back. I think it is a give and take for both of us," said Eddie.

Along with the lab sessions, the patient keeps a daily diary to record what happens during exchanges at home.

Duke and Notre Dame are also involved in the research. This four-year study has had one year left and researchers are still looking for volunteer couples.

For more information on the study, visit: or contact Erik Schuster at 312-942-1435.

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