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31-10-2011 | Psychology | Article

Psychologic factors in patients with neck, lower back pain show high correlation, association


Free abstract

MedWire News: It may not be necessary for spine clinicians to gather detailed information regarding all the known psychologic factors that contribute to neck pain (NP) or lower back pain (LBP), study findings suggest.

"Psychologic factors such as fear, catastrophizing, passive coping, poor self-efficacy, and depression have been found to be important in the perpetuation of pain, disability, and suffering in patients with NP and LBP," explain Donald Murphy (Brown University, Rhode Island, USA) and Eric Hurwitz (University of Hawaii, Mãnoa, USA).

"It is important for spine clinicians to have a screening tool that detects different psychologic factors that are contributing to the patient's suffering with minimal burden to the patient to more strategically use their time in targeting their management to the needs of each patient," they say.

"The challenge with regard to the detection of these factors is that although a variety of reliable and valid instruments has been developed to detect detailed information regarding individual psychologic factors, these instruments are generally time-consuming and/or only detect a single factor, limiting their usefulness for the busy clinician."

The team therefore used established screening tools of different psychologic constructs to investigate whether there is a correlation between various psychologic factors in patients with NP and LBP or whether certain factors are more prominent in certain patients.

Fear beliefs were measured using the 11-item Tamp Scale for Kinesiophobia, explain Murphy and Hurwitz. In addition two questions from the Coping Strategies Questionnaire were used to measure patients' perception of their control over pain. The depression and anxiety subscales of the Bournemouth Disability Questionnaire were used to measure depression and anxiety. A total of 95 patients with NP and 260 with LBP were included in the study.

As reported in the Journal of Manipulative and Physiological Therapeutics, statistically significant correlations were found between each of the psychologic measures in both cohorts, with the exception of depression and coping in patients with NP. Similarly, statistically significant associations were found among all measures in both cohorts with the exception of depression and coping, and coping and fear in patients with NP.

The authors say that knowing these relationships is useful for clinicians because if prognostic factors are related, "identifying and addressing just one might not yield optimal benefit."

However, because the correlations and associations between the psychologic measures were generally high, "it may not be necessary for the spine clinician to gather detailed information regarding all the known psychologic factors that contribute to NP or LBP."

Thus, "a brief screening process that is minimally time-consuming and burdensome to the patient but gather quality information about several psychologic processes may be sufficient," they say. Further investigation is required to confirm this, concludes the team.

By Nikki Withers

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