Pain-related fear in low back pain: a prospective study in the general population.
A cognitive behavioural account of chronic low back pain (CLBP) proposes that the relationship between pain catastrophizing and functional disability is mediated by fear of movement/(re)injury. Several clinical studies already demonstrated the contribution of pain catastrophizing and fear of movement/(re)injury in the development and maintenance of CLBP. This study included people with low back pain (LBP) in the general population, and aimed to investigate whether fear of movement/(re)injury mediated the relationship between pain catastrophizing and functional disability, by examining several prerequisites for mediation. Data from the Dutch population-based Musculoskeletal Complaints and Consequences Cohort (DMC(3)) study were used, including 152 people suffering from LBP who completed both a follow-up questionnaire and a baseline questionnaire 6 months previously. This study was unable to demonstrate that the relationship between pain catastrophizing and functional disability was mediated by fear of movement/(re)injury, since the prerequisite that pain catastrophizing and functional disability were related, was not fulfilled. However, pain catastrophizing was significantly related to fear of movement/(re)injury 6 months later, above and beyond other contributing variables such as fear of movement/(re)injury already present at baseline. On its turn, fear of movement/(re)injury was related to functional disability, in addition to pain intensity. Although this study leaves some indistinctness concerning the actual relationships between pain catastrophizing, fear of movement/(re)injury, and functional disability, it does provide some evidence for the contributing role of these factors in LBP in the general population.
Leeuw
Maaike
M
Department of Medical, Clinical and Experimental Psychology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. M.Leeuw@DMKEP.Unimaas.nl
Houben
Ruud M A
RM
Severeijns
Rudy
R
Picavet
H Susan J
HS
Schouten
Erik G W
EG
Vlaeyen
Johan W S
JW
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000367:Age Factors; D001008:Anxiety Disorders / Q000209:etiology* / Q000523:psychology*; D002908:Chronic Disease; D015331:Cohort Studies; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000150:complications* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010147:Pain Measurement; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires