Pain, Fear Of Pain And Expectancy As Indicators Of Future Disability

Main Category: Back Pain
Also Included In: Pain / Anesthetics
Article Date: 26 Aug 2005 - 14:00 PDT

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Previous research among patients with sub-acute back pain has demonstrated that a negative expectancy for their own prognosis is related to pain and disability at a one year follow-up. However, there is limited understanding of how other variables such as pain intensity and the fear of pain in the future, interrelate with expectation and whether they collectively provide some predictive value for long-term prognosis.

In order to clarify some of these questions, investigators recruited 141 patients with chronic back or neck pain onto this prospective analysis study. Upon commencement of the trial, all of the subjects were measured in terms of pain intensity, pain expectancy, pain related fear (catastrophising / belief) and function. They were then reviewed against the same measures one year later.

Strong interrelations were identified between all of the measured variables. Specifically, negative expectancies were associated with frequent pain and a belief that their condition was derived from a serious underlying medical problem. Patients with negative expectancy and a fear that activity might result in further injury, re-injury or increased pain, displayed significant differences in suffered pain and functional capacity at one year than those with a positive perspective and no fear.

The interrelation between expectancy, pain, catastrophising and fear were shown by the study to be intimately linked, but investigators argue that while this may help direct clinical management, physicians should be cautious about trying to treat any one variable as a discreet and separate symptom.

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