Factors associated with increased risk for pain catastrophizing in patients with chronic neck pain

Background: Insomnia is highly prevalent among people with chronic pain conditions. Because insomnia has been shown to worsen pain, mood, and physical functioning, it could negatively impact the clinical outcomes of patients with chronic pain. Objective: To determine the risk factors associated with clinical insomnia in chronic neck pain (CNP) patients. Study Design: Retrospective analysis. Setting: Outpatient department for interventional pain management at a university hospital. Methods: Data from 218 CNP patients were analyzed in this study. The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ≥ 15). Patient demographics and pain-related factors were evaluated with logistic regression analysis to identify risk factors of clinical insomnia in CNP. Results: In total, 53.7% of patients reported mild to severe insomnia after neck pain development; 22.9% of patients met the criteria for clinically significant insomnia (ISI score ≥ 15). In multivariate analysis, high pain intensity, the presence of comorbid musculoskeletal pain, and a high level of depression were strongly associated with clinical insomnia in patients with CNP. Among these factors, a greater level of depression was the strongest predictor of clinical insomnia, with the highest odds ratio of 3.689 (95% CI 1.570 – 8.667). Limitations: This study was conducted in a single clinical setting including a selected study population with a homogeneous racial background. The ISI does not include several sleep-related variables, the roles of which are unknown in determining insomnia severity. Conclusions: Insomnia should be addressed as an indispensable part of pain management in CNP patients with these risk factors, especially depression. Key words: Chronic neck pain, insomnia, risk factors, pain severity, neuropathic pain, musculoskeletal pain, depression

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Socio-Demographic and Physical Factors Associated with Disability in Adults with Non- Specific Chronic Neck Pain

Medicine & Health ◽

10.17576/mh.2018.1302.12 ◽

2018 ◽

Vol 13 (2) ◽

pp. 122-132

Author(s):

Devinder Kaur Ajit Singh ◽

Keyword(s):

Neck Pain ◽

Chronic Neck Pain ◽

Physical Factors ◽

Factors Associated

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Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study

Pain Research and Treatment ◽

10.1155/2015/327307 ◽

2015 ◽

Vol 2015 ◽

pp. 1-15 ◽

Cited By ~ 10

Author(s):

Irene Campa-Moran ◽

Etelvina Rey-Gudin ◽

Josué Fernández-Carnero ◽

Alba Paris-Alemany ◽

Alfonso Gil-Martinez ◽

...

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Manual Therapy ◽

Pain Catastrophizing ◽

Chronic Neck Pain ◽

Mechanical Hyperalgesia ◽

Time Interval ◽

Dry Needling ◽

Neck Disability ◽

Side Bending

Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT), dry needling and stretching (DN-S), and soft tissue techniques (STT). All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM), pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale). Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation) and DN-S (i.e., side-bending and rotation) groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.

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Pain Neuroscience Education Combined with Therapeutic Exercises Provides Added Benefit in the Treatment of Chronic Neck Pain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168848 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8848

Author(s):

Norollah Javdaneh ◽

Atle Hole Saeterbakken ◽

Arash Shams ◽

Amir Hossein Barati

Keyword(s):

Neck Pain ◽

Self Efficacy ◽

Pain Catastrophizing ◽

Chronic Neck Pain ◽

Fear Avoidance ◽

Fear Avoidance Beliefs ◽

Pain Disability Index ◽

Pain Disability ◽

Therapeutic Exercises ◽

Neuroscience Education

Background: Chronic neck pain is common in the adult general population. Although the etiology of chronic neck pain is under debate, it is clear that chronic neck pain is multifactorial, with both physical and psychosocial contributors. Objective: To determine whether adding pain neuroscience education (PNE) to therapeutic exercises improved their pain–disability index, pain catastrophizing, fear–avoidance beliefs, and pain self-efficacy in subjects with chronic nonspecific neck pain. Methods: This study was a three-arm randomized control trial. Seventy-two patients with chronic nonspecific neck pain were allocated to three groups: therapeutic exercises alone (n = 24), combined (therapeutic exercises + PNE; (n = 24), and a control group (n = 24). Each program took place three times a week, lasting for six weeks. The disability index, pain catastrophizing, fear–avoidance beliefs, and pain self-efficacy measured by the Neck Pain and Disability Scale (NPAD), Pain Catastrophizing Scale (PCS), Fear–Avoidance Beliefs Questionnaire (FABQ), and Pain Self-Efficacy Questionnaire (PSEQ), respectively. Participants were assessed before and after the six-week intervention, and there was no further follow-up. Results: For the outcomes NPAD, PSC, and FABQ, combined intervention demonstrated more significant improvements than therapeutic exercises alone (p ≤ 0.05), whereas no differences were observed between the two intervention groups for PSEQ (p = 0.99). In addition, significant differences were favoring experimental groups versus control for all outcomes (p ≤ 0.001). Conclusion: Therapeutic exercises combined with pain neuroscience education reduced the pain–disability index, pain catastrophizing, and fear–avoidance beliefs more than therapeutic exercises alone in patients with chronic neck pain. For pain self-efficacy, there was no statistically significant difference between the two intervention groups; however, the combined group had a more significant effect than therapeutic exercises alone. Further studies with longer periods and follow-up are required.

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Effects of dry needling on pain, disability, kinesiophobia, pain catastrophizing and psychological distress in patients with chronic neck pain: A randomized controlled pilot study

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200322 ◽

2021 ◽

pp. 1-9

Author(s):

Luis Ceballos-Laita ◽

Ricardo Medrano-de-la-Fuente ◽

Teresa Mingo-Gómez ◽

Ignacio Hernando-Garijo ◽

Elena Estébanez-de-Miguel ◽

...

Keyword(s):

Psychological Distress ◽

Patient Education ◽

Neck Pain ◽

Pain Intensity ◽

Pain Catastrophizing ◽

Chronic Neck Pain ◽

Control Group ◽

Dry Needling ◽

Randomized Controlled ◽

Pain Disability

BACKGROUND: Myofascial trigger points (MTrPs) in neck muscles seem to be related to the main symptoms of patients with chronic neck pain. OBJECTIVE: The objective was to investigate the effects of dry needling (DN) on pain, disability, kinesiophobia, pain catastrophizing and psychological distress in patients with chronic neck pain. METHODS: A double blind randomized controlled pilot trial was designed. Twenty-one patients with chronic neck pain were randomly allocated to the DN group (n= 7), Sham-DN group (n= 7) or Control group (n= 7). All groups received a Transcutaneous Electrical Nerve Stimulation and Therapeutic Ultrasound (TENS/US) protocol with patient education. The DN and Sham-DN groups received two sessions of DN and sham DN, respectively. The primary outcome was pain intensity. Secondary outcomes were disability, kinesiophobia, pain catastrophizing, psychological distress, self-reported improvement and success of blinding. RESULTS: The DN group showed a greater decrease in pain intensity, disability and pain catastrophizing compared to the Sham-DN group (p< 0.05) and the Control group (p< 0.05). The DN group showed the highest self-reported improvement. CONCLUSION: Adding two sessions of DN in active MTrPs in upper trapezius, levator scapulae and sternocleidomastoid muscles to a TENS/US protocol with patient education decreased pain intensity, disability and pain catastrophizing in patients with chronic neck pain.

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Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165950 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5950 ◽

Cited By ~ 1

Author(s):

David Tejera ◽

Hector Beltran-Alacreu ◽

Roberto Cano-de-la-Cuerda ◽

Jose Vicente Leon Hernández ◽

Aitor Martín-Pintado-Zugasti ◽

...

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Pain Catastrophizing ◽

Chronic Neck Pain ◽

Time Factor ◽

Fear Avoidance ◽

Fear Avoidance Beliefs ◽

Time Interaction ◽

Group Time ◽

Neck Disability

Background: Virtual reality (VR) applied to patients with neck pain is a promising intervention to produce positive effects when used alone or combined with exercise. Therefore, the objective of this manuscript is to compare the effects of VR versus exercise treatment on pain intensity, conditioned pain modulation (CPM), temporal summation (TS) and functional and somatosensory outcomes in patients with non-specific chronic neck pain (NS-CNP). Methods: A single-blinded, randomized clinical trial was carried out. A total sample of 44 patients with NS-CNP was randomized into a VR treatment group or neck exercises group. The intervention consisted of two treatment sessions per week, for four weeks and eight sessions. Four measurement moments (at baseline, immediately, 1 month, and 3 months after intervention) were considered. Pain intensity, CPM, TS, functional and somatosensory outcomes were measured. Results: Statistically significant differences were revealed for time factor (F = 16.40, p < 0.01, ηp2 = 0.28) and group*time interaction for kinesiophobia (F = 3.89, p = 0.01, ηp2 = 0.08) showing post-hoc differences in favor of the VR group at 3 months (p < 0.05, d = 0.65). Significant effects were shown for time factor (p < 0.05) but not for the group*time interaction (p > 0.05) for pain intensity, rotation range of motion (ROM), Neck Disability Index, pain catastrophizing, fear-avoidance beliefs, left side pressure pain threshold (PPT) and anxiety. Statistically significant differences were not found for time factor (p > 0.05) and neither in group*time interaction (p > 0.05) for CPM, TS, right side PPT, flexo-extension and lateral-flexion ROM. Conclusions: Kinesiophobia was the only outcome that showed differences between VR and exercise at 3 months. Nevertheless, pain intensity, CPM, TS, ROM, neck disability, pain catastrophizing, fear-avoidance beliefs, PPT and anxiety did not show differences between both interventions.

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Prognostic factors for the improvement of pain and disability following multidisciplinary rehabilitation in patients with chronic neck pain

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04194-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Martin Weigl ◽

Josefine Letzel ◽

Felix Angst

Keyword(s):

Mental Health ◽

Prognostic Factors ◽

Neck Pain ◽

Short Form ◽

Psychosocial Rehabilitation ◽

Chronic Neck Pain ◽

Rehabilitation Programme ◽

Factors Associated ◽

Pain Disability

Abstract Background Recent clinical studies have demonstrated the effectiveness of specific, multidisciplinary, bio-psychosocial, rehabilitation programmes for chronic neck pain. However, prognostic factors for the improvement of pain and disability are mostly unknown. Therefore, the aim of this study was to explore prognostic factors associated with improvements in chronic neck pain following participation in a three-week, multidisciplinary, bio-psychosocial, rehabilitation programme. Methods In this observational, prospective cohort study, a total of 112 patients were assessed at the beginning, end, and 6 months following the completion of a multidisciplinary, bio-psychosocial, rehabilitation programme. Inclusion for participation in the rehabilitation programme depended upon an interdisciplinary pain assessment. The primary outcome was neck pain and disability, which was measured using the Northern American Spine Society questionnaire for pain+disability and was quantified with effect sizes (ES). Multivariable linear regression analyses were used to explore potential prognostic factors associated with improvements in pain and disability scores at discharge and at the 6-month follow-up period. Results The mean age of the patients was 59.7 years (standard deviation = 10.8), and 70.5% were female. Patients showed improvement in pain+disability at discharge (ES = 0.56; p < 0.001), which was sustained at the 6-month follow-up (ES = 0.56; p < 0.001). Prognostic factors associated with improvement in pain+disability scores at discharge included poor pain+disability baseline scores (partial, adjusted correlation r = 0.414, p < 0.001), older age (r = 0.223, p = 0.024), a good baseline cervical active range-of-motion (ROM) (r = 0.210, p < 0.033), and improvements in the Short-form 36 mental health scale (r = 0.197; p = 0.047) and cervical ROMs (r = 0.195, p = 0.048) from baseline values. Prognostic factors associated with improvements in pain+disability at the 6-month follow-up were similar and included poor pain+disability baseline scores (partial, adjusted correlation r = 0.364, p < 0.001), improvements in the Short-form 36 mental health scale (r = 0.232; p = 0.002), cervical ROMs (r = 0.247, p = 0.011), and better cervical ROM baseline scores. However, older age was not a factor (r = 0.134, p = 0.172). Conclusions Future prognostic models for treatment outcomes in chronic neck pain patients should consider cervical ROM and mental health status. Knowledge of prognostic factors may help in the adoption of individualized treatment for patients who are less likely to respond to multidisciplinary rehabilitation.

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