Perceptions of pain and perceptions of health

Perceptions of pain and perceptions of overall health status are complex phenomena. While logically and empirically linked, the direction of influence between the two is uncertain. Is pain one among the many indicators people take into account as they evaluate their general health status? Or are global health perceptions stable aspects of experience which underlie and color more transient experiences such as pain? These are especially interesting questions given recent evidence regarding the power of subjective health assessments in mortality prediction. The relationship between pain and perceptions of health was examined in a sample of 200 randomly selected clients of an outpatient rehabilitation center. Respondents were given a complete musculoskeletal examination by their physician followed by an extensive arthritis pain assessment administered by the staff nurse; instruments used were from the U.S. Public Health Service National Health and Nutrition Examination (NHANES-I). Other data collected by self-report included symptoms elicited by a body systems review, diagnosed chronic disease, functional disability, self-ratings of global health, evaluations of past and future health, and demographic factors. Regression analysis showed that (1) pain had an independent effect on self-perceptions of health net of other health status covariates, (2) self-perceptions of health had an independent effect on pain net of other health status covariates, (3) individuals who evaluated both their past and future health as poor reported more present pain, and (4) individuals who felt their health would be worse in the future reported poorer present health. Findings show that reports of present pain and present global health status were linked to each other and that the sense of an overall health trajectory influenced the interpretation, evaluation, and reporting of current states, both specific and general.