Pain catastrophizing and kinesiophobia: predictors of chronic low back pain.
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.
Picavet
H Susan J
HS
Department of Chronic Disease Epidemiology, National Institute for Public Health and the Environment, Bilthoven, the Netherlands. susan.picavet@rivm.nl
Vlaeyen
Johan W S
JW
Schouten
Jan S A G
JS
D000328:Adult; D001294:Attitude to Health; D003072:Cognition Disorders / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D004522:Educational Status; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010146:Pain / Q000145:classification / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires