Speech motor control and chronic back pain: A preliminary investigation

Abstract

Objectives. Chronic back pain and its sequelae can influence cognitive, affective, and neuromuscular functioning. Speech production-a complex sensorimotor activity-integrates shared cognitive, neuromuscular, and musculoskeletal resources, and therefore could be altered by chronic pain. The purpose of this preliminary investigation was twofold: 1) to determine whether speech alternating motion rates (i.e., speech AMRs) which require rapid, reciprocally coordinated articulatory movements were associated with chronic back pain; and 2) to identify factors that might mediate any observed alterations. Design. Fifty participants, fully or partially disabled by chronic back pain, completed standardized protocols related to pain, depression, disability, medications, as well as speech AMRs. Results. Higher levels of back pain were significantly associated with slower speech AMRs. Stepwise multiple regression assessed the unique and cumulative effects of specific variables such as degree of back pain, depression, level of disability, and medication use on speech motor performance. Speech motor slowness was uniquely related to back pain and the use of nonprescription pain medications, but not to level of depression or disability. Conclusions. Chronic back pain independently influences speech motor rates. Several explanatory models are proposed including pain-induced centrally mediated motor retardation/inhibition, reduced selective attention, and peripherally based "bracing/holding" of shared musculoskeletal environments. © 2009 American Academy of Pain Medicine.