Journal Article

Pain Catastrophizing and Kinesiophobia: Predictors of Chronic Low Back Pain

H. Susan J. Picavet, Johan W. S. Vlaeyen and Jan S. A. G. Schouten

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 156, issue 11, pages 1028-1034
Published in print December 2002 | ISSN: 0002-9262
Published online December 2002 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwf136
Pain Catastrophizing and Kinesiophobia: Predictors of Chronic Low Back Pain

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By using a population-based cohort of the general Dutch population, the authors studied whether an excessively negative orientation toward pain (pain catastrophizing) and fear of movement/(re)injury (kinesiophobia) are important in the etiology of chronic low back pain and associated disability, as clinical studies have suggested. A total of 1,845 of the 2,338 inhabitants (without severe disease) aged 25–64 years who participated in a 1998 population-based questionnaire survey on musculoskeletal pain were sent a second questionnaire after 6 months; 1,571 (85 percent) participated. For subjects with low back pain at baseline, a high level of pain catastrophizing predicted low back pain at follow-up (odds ratio (OR) = 1.7, 95% confidence interval (CI): 1.0, 2.8) and chronic low back pain (OR = 1.7, 95% CI: 1.0, 2.3), in particular severe low back pain (OR = 3.0, 95% CI: 1.7, 5.2) and low back pain with disability (OR = 3.0, 95% CI: 1.7, 5.4). A high level of kinesiophobia showed similar associations. The significant associations remained after adjustment for pain duration, pain severity, or disability at baseline. For those without low back pain at baseline, a high level of pain catastrophizing or kinesiophobia predicted low back pain with disability during follow-up. These cognitive and emotional factors should be considered when prevention programs are developed for chronic low back pain and related disability.

Keywords: back pain; cognition disorders; emotions; pain; population; questionnaires; Abbreviations: CI, confidence interval; DMC3, Dutch population-based Musculoskeletal Complaints and Consequences Cohort; OR, odds ratio; TSK, Tampa Scale of Kinesiophobia.

Journal Article.  4150 words.  Illustrated.

Subjects: Public Health and Epidemiology

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