“I See What Others Don’t See When They Look at Me”: A Qualitative Study of Body Perception Disturbances in Chronic Non-Cancer Pain

Marion Dagenais,1,2 Jean-Sébastien Roy,1,2 Anne Marie Pinard,1– 3 Catherine Mercier1,2 1Faculty of Medicine, Laval University, Quebec City, QC, Canada; 2Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), CIUSSS de la Capitale-Nationale (Integrated University Health and Social Services Center for Capitale-Nationale), Quebec City, QC, Canada; 3CHU de Québec-Université Laval (Quebec City – Laval University Hospital Center), Quebec City, QC, CanadaCorrespondence: Catherine Mercier, Email [email protected]: Body perception disturbances, such as distorted perception of limb size, are well documented in specific pain conditions like complex regional pain syndrome but remain underexplored in chronic pain more broadly. This qualitative study aimed to explore how body perception disturbances manifest in individuals with chronic non-cancer pain.Materials and Methods: Semi-structured interviews were conducted on a purposive sample of 15 adults (4 men; age range: 26– 76 years) with various chronic pain conditions (eg, fibromyalgia, musculoskeletal pain, migraine, endometriosis), pain severity (average pain intensity: 3 to 7.5 on a 0– 10 scale) and duration (range: 0.5– 53 years), and work status (eg, full-time worker, permanent disability). Interview transcripts were analyzed based on inductive/deductive hybrid thematic analysis principles.Results: All participants reported body perception disturbances. Six main themes emerged, encompassing 21 sub-themes in total. The six main themes were as follows: (1) distortions of perceived body characteristics; (2) altered proprioceptive and postural awareness; (3) a shifted focus toward or away from the pain; (4) perturbed emotions and beliefs about the body; (5) neglect-like symptoms; and (6) a disturbed sense of agency.Conclusion: Our results suggest that body perception disturbances are a common phenomenon across several chronic non-cancer pain conditions. Future research should examine body perception disturbances in large, heterogeneous samples to further describe its key features and underlying mechanisms.Keywords: chronic pain, qualitative, body schema, body image, body ownership, distortion