The influence of pain catastrophizing and central sensitization on the reported pain after hip arthroscopy

Niels H Bech,Aleid De Rooij,Gino M M J Kerkhoffs,Inger N Sierevelt,Daniel Haverkamp

doi:10.1007/s00167-021-06658-w

Abstract

PurposeThis study was conducted to investigate whether the pain catastrophizing scale (PCS) and the central sensitization inventory (CSI) are predictive factors for the reported pain after hip arthroscopy.MethodsA total of 37 patients undergoing hip arthroscopy for femoroacetabular impingement syndrome and labral tears were prospectively enrolled. All patients completed the PCS and CSI before hip arthroscopy. Postoperative pain was measured with the numeric rating scale (NRS) weekly the first 12 weeks after surgery by electronic diary.ResultsAt baseline, univariate analyses showed that both the CSI and PCS were significantly associated with the NRS outcome (p < 0.01). During 12 weeks follow-up, a significant decrease on the NRS was observed (p < 0.01). Univariate analyses showed that both the CSI and PCS were significantly associated with the NRS during follow-up. Multivariate mixed model analysis showed that only the PCS remained significantly associated with the NRS outcome with a ß of 0.07 (95% CI 0.03–0.11, p < 0.01).ConclusionResults indicate that both the PCS and CSI are associated with the reported postoperative pain after hip arthroscopy. The PCS and CSI may be useful in daily practice to identify patients that possibly benefit from pain catastrophizing reduction therapy (e.g. counseling) prior to surgery.Level of evidenceIV

Highlights

Postoperative pain after hip arthroscopy is usually measured as numeric rating scale (NRS) and is commonly used as outcome after surgery [17]
The aim of this study is to investigate the role of pain catastrophizing (PC) and central sensitization (CS) on the reported pain after hip arthroscopy and the hypothesis is that both CS and PC are of influence on the reported pain after hip arthroscopy
Multivariate mixed model analysis showed that only the pain catastrophizing scale (PCS) remained significantly associated with the NRS outcome with a ß of 0.06 (Table 2)

Summary

Introduction

Postoperative pain after hip arthroscopy is usually measured as numeric rating scale (NRS) and is commonly used as outcome after surgery [17]. Measuring of postoperative pain with the NRS is well validated there are several patient-related factors that might influence the reported postoperative NRS score. Other non-orthopedic factors, such as patient mental health and psychological state, might influence the reported postoperative pain as well [10, 12, 27]. One of those factors might be central sensitization (CS) in which an abnormal enhancement of the pain mechanism may be present involving the central nervous system [20, 22].

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