Changing pain expectations: the role of social context and communication

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In everyday life and in clinical practice, people often have expectations about future pain outcomes. Such expectations have a strong, well-documented influence on future pain experiences and responses to pain1,13 and are a major predictor of pain treatment outcomes.2,3 Mun et al. (this issue of PAIN11) add to this vast literature by confirming the influence of pain expectations on pain perception in the daily lives of patients with chronic pain. Indeed, an important contribution of this work is the use of daily diaries that allow the examination of pain expectations and how they vary in a dynamic, natural setting. More specifically, in 2 independent studies, patients with persistent pain (rheumatoid arthritis and fibromyalgia, respectively) reported on their daily pain and expected pain for the next day for several days. Moreover, to broaden the view on pain expectations, the patients in Study 2 were also asked to assess their interpersonal experiences during these days, as well as potential affective and cognitive predictors of pain expectations. The findings of this second diary study extend current insights on the influence of pain expectations, by suggesting their impact on social enjoyment through increased pain. Furthermore, expectations for pain appeared to vary as a function of positive affect and interference of pain with daily activities. These novel insights are important because they contribute to a better understanding of the predictors and dynamics of pain expectations, which will allow better targeted pain treatment and prevention.
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