Musculoskeletal pain in primary health care: subgroups based on pain intensity, disability, self-efficacy, and fear-avoidance variables.
The purpose of this study was to identify and describe subgroup profiles based on self-reported pain intensity, disability, self-efficacy, fear of movement/(re)injury, and catastrophizing in patients with musculoskeletal pain. Two primary health care samples (n = 215 and n = 161) were used. Self-report questionnaires were completed at the start of physical therapy treatment. Cluster analysis was used to generate subgroups. Three subgroups were identified in sample 1 and replicated in sample 2. These were labeled "High self-efficacy-Low fear-avoidance," "Low self-efficacy-Low fear-avoidance," and "Low self-efficacy-High fear-avoidance." The subgroups differed significantly in work-status in both samples (P < .001), but not in age, gender, or duration of pain. The results show the presence of subgroups based on pain intensity, disability, self-efficacy, fear of movement/(re)injury, and catastrophizing. The profile patterns suggest that different management strategies may be relevant in each subgroup.


CONCLUSIONS
This article presents subgroups of patients with musculoskeletal pain with different profiles in pain intensity, disability, and psychosocial variables possible to modify by physical therapy management. The results could potentially aid clinicians in tailoring assessment and treatment approaches to each subgroup.
Denison
Eva
E
Section of Caring Sciences, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. eva.denison@mdh.se
Asenlöf
Pernilla
P
Sandborgh
Maria
M
Lindberg
Per
P
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D016000:Cluster Analysis; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000523:psychology*; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement; D011320:Primary Health Care; D015203:Reproducibility of Results; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D014937:Work