Evidences of memory dysfunction and maladaptive coping in chronic low back pain and rheumatoid arthritis patients: challenges for rehabilitation.

Aim: This study investigates whether chronic low back pain (LBP) and rheumatoid arthritis (RA) patients have deficits in memory functioning and whether there is correlation between memory scores and coping skills, as a disability evaluation measure.

Methods: We studied 2 samples of patients of both genders between 20 and 70 years-old, in a cross-sectional design: 21 low back pain and 23 rheumatoid arthritis. Patients were compared to historical controls. Assessment of primary outcome included memory evaluation (Wechsler Memory Scale III) and measures of coping strategies (FABQ, CPCI, CSQ). Other data included depression (HAD), pain (VAS), work status, use of medications, and perceived memory complaints. Analysis were made of between-group differences.

Results: Both groups were comparable regarding demographic status, had high scores of memory complaint, and low performance in memory assessment when compared to normative data. Only LBP patient's measures of catastrophizing and coping were significantly correlated to late memory indices. No correlations were found between memory and Visual Analogue Scale (VAS) or pain chronicity in both groups. One may suggest that both chronic localized and widespread pain can imply in cognitive changes and be correlated to coping dysfunction. However, bias of existence of depression/ anxiety and psychotropic medication cannot be excluded.

Conclusions: Both groups of chronic pain patients are likely to have impaired memory. Maladaptive coping correlates to LBP, but not to RA. A further controlled protocol must include greater sample of patients. By analyzing memory deficits of chronic pain patients, clinicians could establish targeted rehabilitation programs and outcomes. Some techniques are discussed.