Effects of symbolic function on pain experience and vocational outcome in patients with chronic neck pain referred to the evaluation of surgical intervention: 6-year follow-up.

Abstract

Objectives: This study examined the relationship between symbolic function, coping, pain, and long-term outcomes in patients with chronic cervical pain.

Methods: The study population consisted of 104 subjects who could be candidates for cervical spinal surgery at the Department of Neurosurgery. We followed patients for 2 and 6 years, focusing on pain experience, vocational outcome, and sick leave.

Results: The SAT9 test revealed that 28% of the patients had poor symbolic function. The group classified as having poor symbolic function reported using more coping strategies and coping resources but had more of an external locus of control. They showed less objective neurophysiological findings but rated more pain on the VAS scale. The group with poor symbolic function had more sick leave days 2 years after consultation, and the vocational outcome was very poor for persons with impaired symbolic function at the 6-year follow-up. At the 6-year follow-up, patients with poor symbolic function still experienced higher pain levels and had more of an external locus of control.

Conclusions: The SAT9 results indicate that pain could also serve as an expression of distress or discomfort, and the expression of pain can be a way for individuals to communicate their need for rest, recovery, or relief from stressors. In this context, taking sick leave becomes a symbolic action addressing broader well-being concerns. Understanding the symbolic function of stress and pain concerns can be valuable for health professionals and individuals themselves. Open communication, recognizing, and reorganizing the symbolic nature of pain can contribute to a more compassionate understanding of stress-related challenges and pain.