Abstract

Numerous studies have shown that pain-related fear is one of the strongest predictors of pain disability in patients with chronic musculoskeletal pain, and there is evidence that the reduction of pain-related fear through an exposure treatment can be associated with restoration of functional abilities in patients with complex regional pain syndrome type I (CRPS-I). These findings suggest that pain-related fear may be associated with functional limitations in neuropathic pain as well. The aim of the current study was to test whether the debilitating role of pain-related fear generalizes to patients with CRPS-I. The results of 2 studies are presented. Study I includes a sample of patients with early CRPS-I referred to an outpatient pain clinic. In Study II, patients with chronic CRPS who are members of a patients' association were invited to participate. The results show that in early CRPS-I, pain severity but not fear of movement/(re)injury as measured with the Tampa Scale for Kinesiophobia was related to functional limitations. In patients with chronic CRPS-I, however, perceived harmfulness of activities as measured with the pictorial assessment method significantly predicted functional limitations beyond and above the contribution of pain severity. Not fear of movement/(re)injury in general, but the perceived harmfulness of activities appears a key factor that might be addressed more systematically in the clinical assessment of patients with CRPS-I. These results support the idea that pain-related fear might be a promising concept in the understanding of pain disability in patients with neuropathic pain. PERSPECTIVE: This is the first study showing that perceived harmfulness of activities contribute to the functional limitations in CRPS-I. The current findings may help clinicians customizing cognitive-behavioral treatments for patients with chronic neuropathic pain.

Links

Publisher Full Text

Authors

de Jong JR, Vlaeyen JW, de Gelder JM, Patijn J

Institution

Department of Rehabilitation, University Hospital Maastricht, Maastricht, The Netherlands. jeroen.dejong@mumc.nl

Source

The journal of pain : official journal of the American Pain Society 12:12 2011 Dec pg 1209-18

MeSH

Activities of Daily Living
Adolescent
Adult
Aged
Aged, 80 and over
Aging
Cross-Sectional Studies
Data Interpretation, Statistical
Fear
Female
Humans
Male
Middle Aged
Movement
Pain
Pain Measurement
Reflex Sympathetic Dystrophy
Regression Analysis
Sex Characteristics
Socioeconomic Factors
Young Adult

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22033012