The prevalence of fear avoidance and pain catastrophising amongst patients with chronic neck pain.

Clare Cresswell,Hellen Myezwa,Mary L. Galantino

doi:10.4102/sajp.v76i1.1326

Clare Cresswell, Hellen Myezwa + Show 1 more

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https://doi.org/10.4102/sajp.v76i1.1326

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Abstract

BackgroundCognitive factors impact chronic pain, but the prevalence of fear avoidance (FA) and pain catastrophising (PC) in individuals suffering from chronic neck pain (CNP) has not been investigated in South Africa.ObjectivesTo determine the prevalence of FA and PC in patients with CNP at private physiotherapy practices in Johannesburg.MethodThe Tampa Scale for Kinesiophobia-11 (TSK-11) (α = 0.80) and Pain Catastrophising Scale (α = 0.87) self-report questionnaires were used in a cross-sectional study to determine the prevalence of FA and PC, respectively. Descriptive statistics and correlations using Pearson’s or Spearman’s coefficient were conducted between demographic variables and FA and PC. Non-parametric data were tested using the Wilcoxon rank-sum or Kruskal–Wallis test. Cohen’s d-value or r-value measured strength of associations.ResultsA sample of 106 CNP patients with a mean age of 48.7 years (± 14.8) from 25 randomly selected private practices participated in the study. Of the participants, 81% were women (n = 86). Fear avoidance and PC had a prevalence of 25.5% (n = 27) and 15.1% (n = 16), respectively. A positive correlation was found between FA-11-Total and PC-Total (r = 0.684; p = 0.0001) and between FA (TSK-11-Total and TSK-SF (somatic focus)) and PC and its subscales (r ≥ 0.602; p = 0.0001). Participants with a secondary education (26.0 ± 3.4) showed a higher FA than those with tertiary education (21.9 ± 1.5). Effect size was moderate (Cohen’s d = 0.60). Pain intensity correlated positively with both FA (Pearson’s correlation: r = 0.33; p = 0.001) and PC (Spearman’s correlation; r = 0.39; p = 0.0001).ConclusionFA and PC affect a number of patients with CNP. A lower level of education was associated with FA and a higher pain intensity was associated with higher FA and PC.Clinical implicationsIdentifying FA and PC in patients with CNP is important to facilitate holistic management.

Highlights

Chronic neck pain (CNP), with resultant disability, is common in the general population (Carroll et al 2008), with studies showing that between 50% and 85% of those in pain are likely to experience recurring episodes of neck pain (Haldeman et al 2010)
A cross-sectional study used two validated self-report questionnaires to investigate the prevalence of fear avoidance (FA) (Woby et al 2005) and pain catastrophising (PC) (Sullivan et al 1995) in patients suffering from chronic neck pain (CNP) for longer than 3 months
Because our study primarily investigated the prevalence of FA and PC, we were unable to include the impact of co-morbidities on these cognitive factors

Summary

Introduction

Chronic neck pain (CNP), with resultant disability, is common in the general population (Carroll et al 2008), with studies showing that between 50% and 85% of those in pain are likely to experience recurring episodes of neck pain (Haldeman et al 2010). Different pain syndromes can be viewed as having their origins predominantly in a cognitive and affective environment as a result of a motor mechanism, an autonomic mechanism, a combination of some of them or all of them (Bolay & Moskowitz 2002). Cognitive factors impact chronic pain, but the prevalence of fear avoidance (FA) and pain catastrophising (PC) in individuals suffering from chronic neck pain (CNP) has not been investigated in South Africa

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