The degree of chronic pain suffered is varied, and does not always correlate with the changes seen on x-ray, or even MRI. Pain and restricted function are associated with more depressive symptoms, and the existence of depression has predicted which patients might worsen over time, including who would respond better to a given treatment. Not surprisingly, the group of individuals with the most problematic psychological profile also show the greatest levels of pain and disability. On the other hand, subjects with the lowest level of central arousability and attention to pain, and the highest level of optimism, were the least sensitive to pain stimuli.
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