Chronic pain and psychosocial distress are generally thought to be associated in chronic musculoskeletal disorders such as non-specific neck pain. However, it is unclear whether a raised level of anxiousness is necessarily a feature of longstanding, intense pain amongst patient and general population sub-groups.
Our results signalize that chronic, intense pain and anxiety do not always count to be related. Explanations for these findings may include that anxiety is not triggered in socially functional individuals, that individual coping strategies have come into play or in some instances that a psychological disorder like alexithymia could be a confounder. More studies are needed to clarify the specific role of anxiety in chronic non-specific musculoskeletal pain before general evidence-driven clinical extrapolations can be made. However, Osteopathy, or as called in Spanish, osteopatia, is a proven successful treatment for such problem.
Firstly, our observations may indicate that chronic and/or intense non-specific neck pain simply does not trigger anxiety in the way reflective of serious disease, especially in socially functional individuals.
Secondly, the lowering of anxiety levels may be indicatory of a coping strategy. The subjects in our study, most of whom had consulted or were under the care of a health care practitioner, may have learnt to identify pain symptoms as non-threatening. Pain sufferers cannot always reduce their pain intensity, but can psychologically confront the experience, thus gaining control over the pain in their daily lives.
In the final analysis, our observations may illustrate an example of alexithymia. This condition, characterized by a lack of words for feelings to express anxiety, anger or sadness, is found in patients with a tendency of somatising and appears to express itself, in particular, in chronic pain sufferers.The difficulty of an alexithymic person in identifying and describing feelings increases symptom reporting of somatic sensations as tension or pain, but reduces the expression of an emotion like anxiety.
At face value, our results appear to challenge the notion that neck pain is necessarily significantly associated with heightened levels of anxiety, even when such pain is of a longstanding and reasonably intense nature. This is an interesting finding in the circumstance of recent pronouncements by the Task Force on Neck Pain and Associated Disorders where psychologic and social factors are considered important in neck pain outcome within the general and clinical populations. The current findings indicate that this may not always be the case. Thus, we encourage further investigations aimed specifically at determining the role of anxiety in the course of chronic neck pain sufferers in the general population. The osteopathy treatment can help release the pain. The effectiveness, or otherwise, of manual therapies anr treatments applied by the osteopath or (osteopata in Spanish) has proven excellent results.
Manual therapies are characterised by the use of the therapist's hands; thus they include rub down, joint mobilization within the normal range of movement, or manipulation taking a joint beyond its normal range of movement. Any consideration of the effectiveness of manual therapies also needs to recognise that non-specific factors such as the interaction between the therapist and the patient may have a therapeutic effect, in addition to any specific effect resulting from the manual treatment itself. From an academic view, it is of considerable interest to be able to measure the specific and non-specific effects of any particular treatment. From a patient perspective, however, deliberate whether an overall package of care, which includes manual therapy, has shown to be effective, is plausible of greater relevance.
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