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Journal of Occupational Rehabilitation

Erschienen in:

01.03.2006

Fear-Avoidance Beliefs and Temporal Summation of Evoked Thermal Pain Influence Self-Report of Disability in Patients With Chronic Low Back Pain

verfasst von: Steven Z. George, Virgil T. Wittmer, Roger B. Fillingim, Michael E. Robinson

Erschienen in: Journal of Occupational Rehabilitation | Ausgabe 1/2006

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Abstract

Introduction: Quantitative sensory testing has demonstrated a promising link between experimentally determined pain sensitivity and clinical pain. However, previous studies of quantitative sensory testing have not routinely considered the important influence of psychological factors on clinical pain. This study investigated whether measures of thermal pain sensitivity (temporal summation, first pulse response, and tolerance) contributed to clinical pain reports for patients with chronic low back pain, after controlling for depression or fear-avoidance beliefs about work. Method: Consecutive patients (n=27) with chronic low back pain were recruited from an interdisciplinary pain rehabilitation program in Jacksonville, FL. Patients completed validated self-report questionnaires for depression, fear-avoidance beliefs, clinical pain intensity, and clinical pain related disability. Patients also underwent quantitative sensory testing from previously described protocols to determine thermal pain sensitivity (temporal summation, first pulse response, and tolerance). Hierarchical regression models investigated the contribution of depression and thermal pain sensitivity to clinical pain intensity, and fear-avoidance beliefs and thermal pain sensitivity to clinical pain related disability. Results: None of the measures of thermal pain sensitivity contributed to clinical pain intensity after controlling for depression. Temporal summation of evoked thermal pain significantly contributed to clinical pain disability after controlling for fear-avoidance beliefs about work. Conclusion: Measures of thermal pain sensitivity did not contribute to pain intensity, after controlling for depression. Fear-avoidance beliefs about work and temporal summation of evoked thermal pain significantly influenced pain related disability. These factors should be considered as potential outcome predictors for patients with work-related low back pain. Signifance: This study supported the neuromatrix theory of pain for patients with CLBP, as cognitive-evaluative factor contributed to pain perception, and cognitive-evaluative and sensory-discriminative factors uniquely contributed to an action program in response to chronic pain. Future research will determine if a predictive model consisting of fear-avoidance beliefs and temporal summation of evoked thermal pain has predictive validity for determining clinical outcome in rehabilitation or vocational settings.

Lautenbacher S, Fillingim RB. Pathophysiology of pain perception, 1st edn. New York: Kluwer, 2004.

Edwards RR, Sarlani E, Wesselmann U, Fillingim RB. Quantitative assessment of experimental pain perception: multiple domains of clinical relevance. Pain 2005; 114: 315–319.PubMedCrossRef

Staud R, Vierck CJ, Cannon RL, Mauderli AP, and Price DD. Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain 2001; 91: 165–175.PubMedCrossRef

Staud R, Robinson ME, Vierck CJ, Jr, Cannon RC, Mauderli AP, Price DD. Ratings of experimental pain and pain-related negative affect predict clinical pain in patients with fibromyalgia syndrome. Pain 2003; 105: 215–222.PubMedCrossRef

Staud R, Cannon RC, Mauderli AP, Robinson ME, Price DD, Vierck CJ, Jr. Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome. Pain 2003; 102: 87–95.PubMedCrossRef

Granot M, Friedman M, Yarnitsky D, Zimmer EZ. Enhancement of the perception of systemic pain in women with vulvar vestibulitis. BJOG 2002; 109: 863–866.PubMedCrossRef

Giesecke T, Gracely RH, Grant MA, Nachemson A, Petzke F, Williams DA, Clauw DJ. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum. 2004; 50: 613–623.PubMedCrossRef

Derbyshire SW, Jones AK, Creed F, Starz T, Meltzer CC, Townsend DW, Peterson AM, Firestone L. Cerebral responses to noxious thermal stimulation in chronic low back pain patients and normal controls. Neuroimage 2002; 16: 158–168.PubMedCrossRef

Flor H, Knost B, Birbaumer N. The role of operant conditioning in chronic pain: An experimental investigation. Pain 2002; 95: 111–118.PubMedCrossRef

10.

Johnson MH, Petrie SM. The effects of distraction on exercise and cold pressor tolerance for chronic low back pain sufferers. Pain 1997; 69: 43–48.PubMedCrossRef

11.

Kleinbohl D, Holzl R, Moltner A, Rommel C, Weber C, Osswald PM. Psychophysical measures of sensitization to tonic heat discriminate chronic pain patients. Pain 1999; 81: 35–43.PubMedCrossRef

12.

Brands AM, Schmidt AJ. Learning processes in the persistence behavior of chronic low back pain patients with repeated acute pain stimulation. Pain 1987; 30: 329–337.PubMedCrossRef

13.

Yamashita T, Kanaya K, Sekine M, Takebayashi T, Kawaguchi S, Katahira G. A quantitative analysis of sensory function in lumbar radiculopathy using current perception threshold testing. Spine 2002; 27: 1567–1570.PubMedCrossRef

14.

Zwart JA, Sand T, Unsgaard G. Warm and cold sensory thresholds in patients with unilateral sciatica: C fibers are more severely affected than A-delta fibers. Acta Neurol. Scand. 1998; 97: 41–45.PubMedCrossRef

15.

Quraishi NA, Taherzadeh O, McGregor AH, Hughes SP, Anand P. Correlation of nerve root pain with dermatomal sensory threshold and back pain with spinal movement in single level lumbar spondylosis. J Bone Joint Surg Br 2004; 86: 74–80.PubMed

16.

Clauw DJ, Williams D, Lauerman W, Dahlman M, Aslami A, Nachemson A, Kobaine AL, Wiesel SW. Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain. Spine 1999; 24: 2035–1041.PubMedCrossRef

17.

Takahashi Y, Takahashi K, Moriya H. Thermal deficit in lumbar radiculopathy. Correlations with pain and neurologic signs and its value for assessing symptomatic severity. Spine 1994; 19: 2443–2449.PubMedCrossRef

18.

Pincus T, Burton AK, Vogel S, Field AP. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine 2002; 27: E109–E120.PubMedCrossRef

19.

Linton SJ. A review of psychological risk factors in back and neck pain. Spine 2000; 25: 1148–1156.PubMedCrossRef

20.

Atkinson JH, Slater MA, Patterson TL, Grant I, Garfin SR. Prevalence, onset, and risk of psychiatric disorders in men with chronic low back pain: a controlled study. Pain 1991; 45: 111–121.PubMedCrossRef

21.

Currie SR, Wang J. Chronic back pain and major depression in the general Canadian population. Pain 2004; 107: 54–60.PubMedCrossRef

22.

Haggman S, Maher CG, Refshauge KM. Screening for symptoms of depression by physical therapists managing low back pain. Phys.Ther. 2004; 84: 1157–1166.PubMed

23.

Dionne CE, Koepsell TD, Von Korff M, Deyo RA, Barlow WE, Checkoway H. Predicting long-term functional limitations among back pain patients in primary care settings. J.Clin.Epidemiol. 1997; 50: 31–43.PubMedCrossRef

24.

Epping-Jordan JE, Wahlgren DR, Williams RA, Praitt SD, Slater MA, Patterson TL, Grand I, Webster JS, Alkinson JH Transition to chronic pain in men with low back pain: Predictive relationships among pain intensity, disability, and depressive symptoms. Health Psychol. 1998; 17: 421–427.PubMedCrossRef

25.

Cherkin DC, Deyo RA, Street JH, Barlow W. Predicting poor outcomes for back pain seen in primary care using patients’ own criteria. Spine 1996; 21: 2900–297.PubMedCrossRef

26.

Lethem J, Slade PD, Troup JDG, Bentley G. Outline of a fear-avoidance model of exaggerated pain perception-I. Behav Res Ther 1983; 21: 401–408.PubMedCrossRef

27.

Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000; 85: 317–332.PubMedCrossRef

28.

Asmundson GJ, Norton GR, Allerdings MD. Fear and avoidance in dysfunctional chronic back pain patients. Pain 1997; 69: 231–236.PubMedCrossRef

29.

Crombez G, Vlaeyen JW, Heuts PH, Lysens R. Pain-related fear is more disabling than pain itself: Evidence on the role of pain-related fear in chronic back pain disability. Pain 1999; 80: 329–339.PubMedCrossRef

30.

Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 1993; 52: 157–168.PubMedCrossRef

31.

Fritz JM, George SZ, Delitto A. The role of fear avoidance beliefs in acute low back pain: Relationships with current and future disability and work status. Pain 2001; 94: 7–15.PubMedCrossRef

32.

Klenerman L, Slade PD, Stanley IM, Pennie B, Reilly JP, Atchson LE, Troup JD, Rose MJ. The prediction of chronicity in patients with an acute attack of low back pain in a general practice setting. Spine 1995; 20: 478–484.PubMedCrossRef

33.

Sieben JM, Vlaeyen JW, Tuerlinckx S, Portegijs PJ. Pain-related fear in acute low back pain: the first two weeks of a new episode. Eur J Pain 2002; 6: 229–237.PubMedCrossRef

34.

Fuller AK, Robinson ME. Perceptual differences between chronic low-back pain patients and healthy volunteers using magnitude matching and clinically relevant stimuli. Behavior Therapy 1995; 26: 241–253.CrossRef

35.

Melzack R. From the gate to the neuromatrix. Pain 1999; Suppl 6: S121–S126.PubMedCrossRef

36.

Melzack R. Pain and the neuromatrix in the brain. J Dent Educ 2001; 65: 1378–82.PubMed

37.

Scientific approach to the assessment and management of activity-related spinal disorders. A monograph for clinicians. Report of the Quebec Task Force on Spinal Disorders. Spine 1987; 12: S1–S59.

38.

Price DD, Staud R, Robinson ME, Mauderli AP, Cannon R, Vierck CJ. Enhanced temporal summation of second pain and its central modulation in fibromyalgia patients. Pain 2002; 99: 49–59.PubMedCrossRef

39.

Robinson ME, Wise EA, Gagnon C, Fillingim RB, Price DD. Influences of gender role and anxiety on sex differences in temporal summation of pain. J Pain 2004; 5: 77–82.PubMedCrossRef

40.

Bhalang K, Sigurdsson A, Slade GD, Maixner W. Associations among four modalities of experimental pain in women. J Pain 2005; 6: 604–611.PubMedCrossRef

41.

Geisser ME, Robinson ME, Pickren WE. Differences in cognitive coping strategies among pain sensitive and pain tolerant individuals on the cold pressor test. Behav Ther 1992; 23: 31–41.CrossRef

42.

Price DD. Psychological mechanisms of pain and analgesia. Seattle, WA: IASP Press, 1999.

43.

Price DD, Harkins SW, Baker C. Sensory-affective relationships among different types of clinical and experimental pain. Pain 1987; 28: 297–307.PubMedCrossRef

44.

Rainville P, Feine JS, Bushnell MC, Duncan GH. A psychophysical comparison of sensory and affective responses to four modalities of experimental pain. Somatosens. Mot Res 1992; 9: 265–277.

45.

Beck AT, Steer RA. Beck Depression Inventory Manual. San Antonio, TX: The Psychological Corporation, 1987.

46.

Geisser ME, Roth RS, Robinson ME. Assessing depression among persons with chronic pain using the Center for Epidemiological Studies-Depression Scale and the Beck Depression Inventory: A comparative analysis. Clin J Pain 1997; 13: 163–170.PubMedCrossRef

47.

Furlanetto LM, Mendlowicz MV, Romildo BJ. The validity of the Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. J Affect Disord 2005; 86: 87–91.PubMedCrossRef

48.

Leentjens AF, Verhey FR, Luijckx GJ, Troost J. The validity of the Beck Depression Inventory as a screening and diagnostic instrument for depression in patients with Parkinson’s disease. Mov Disord 2000; 15: 1221–1224.PubMedCrossRef

49.

Lasa L, Ayuso-Mateos JL, Vazquez-Barquero JL, Diez-Manrique FJ, Dowrick CF. The use of the Beck Depression Inventory to screen for depression in the general population: a preliminary analysis. J Affect Disord 2000; 57: 261–265.PubMedCrossRef

50.

Arnau RC, Meagher MW, Norris MP, Bramson R. Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients. Health Psychol 2001; 20: 112–9.PubMedCrossRef

51.

Burckhardt CS, O’Reilly CA, Wiens AN, Clark SR, Campbell SM, Bennett RM. Assessing depression in fibromyalgia patients. Arthrit Care Res 1994; 7: 35–39.CrossRef

52.

Al Musawi NM. Psychometric properties of the beck depression inventory-II with university students in Bahrain. J Pers Assess 2001; 77: 568–79.PubMedCrossRef

53.

Enns MW, Cox BJ, Parker JD, Guertin JE. Confirmatory factor analysis of the Beck Anxiety and Depression Inventories in patients with major depression. J Affect Disord 1998; 47: 195–200.PubMedCrossRef

54.

Jacob T, Baras M, Zeev A, Epstein L. Low back pain: reliability of a set of pain measurement tools. Arch Phys Med Rehabil 2001; 82: 735–742.PubMedCrossRef

55.

Pfingsten M, Kroner-Herwig B, Leibing E, Kronshage U, Hildebrandt J. Validation of the German version of the Fear-Avoidance Beliefs Questionnaire (FABQ). Eur J Pain 2000; 4: 259–266.CrossRef

56.

Holm I, Friis A, Storheim K, Brox JI. Measuring Self-Reported Functional Status and Pain in Patients with Chronic Low Back Pain by Postal Questionnaires: A Reliability Study. Spine 2003; 28: 828–833.PubMedCrossRef

57.

Roach KE, Brown MD, Dunigan KM, Kusek CL, Walas M. Test-retest reliability of patient reports of low back pain. J Orthop Sports Phys Ther 1997; 26: 253–259.PubMed

58.

Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983; 17: 45–56.PubMedCrossRef

59.

Jensen MP, Turner LR, Turner JA, Romano JM. The use of multiple-item scales for pain intensity measurement in chronic pain patients. Pain 1996; 67: 35–40.PubMedCrossRef

60.

Fairbank JC, Couper J, Davies JB, O’Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy 1980; 66: 271–273.PubMed

61.

Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine 2000; 25: 2940–2953.PubMedCrossRef

62.

Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine 2000; 25: 3115–3124.PubMedCrossRef

63.

Edwards RR, Haythornthwaite JA, Sullivan MJ, Fillingim RB. Catastrophizing as a mediator of sex differences in pain: Differential effects for daily pain versus laboratory-induced pain. Pain 2004; 111: 335–241.PubMedCrossRef

64.

Edwards RR,Fillingim RB. Effects of age on temporal summation and habituation of thermal pain: Clinical relevance in healthy older and younger adults. J Pain 2001; 2: 307–17.PubMedCrossRef

65.

Giesecke T, Williams DA, Harris RE, et al. Subgrouping of fibromyalgia patients on the basis of pressure-pain thresholds and psychological factors. Arthrit Rheum. 2003; 48: 2916–2922.CrossRef

66.

Edwards RR, Doleys DM, Lowery D, Fillingim RB. Pain tolerance as a predictor of outcome following multidisciplinary treatment for chronic pain: Differential effects as a function of sex. Pain 2003; 106: 419–426.PubMedCrossRef

67.

Schiff E, Eisenberg E. Can quantitative sensory testing predict the outcome of epidural steroid injections in sciatica? A preliminary study. Anesth Analg 2003; 97: 828–832.PubMedCrossRef

68.

Fritz JM, George SZ. Identifying psychosocial variables in patients with acute work-related low back pain: The importance of fear-avoidance beliefs. Phys Ther 2002; 82: 973–983.PubMed

Titel: Fear-Avoidance Beliefs and Temporal Summation of Evoked Thermal Pain Influence Self-Report of Disability in Patients With Chronic Low Back Pain
verfasst von: Steven Z. George
Virgil T. Wittmer
Roger B. Fillingim
Michael E. Robinson
Publikationsdatum: 01.03.2006
Verlag: Springer US
Erschienen in: Journal of Occupational Rehabilitation / Ausgabe 1/2006
Print ISSN: 1053-0487
Elektronische ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-005-9007-y

Springer Medizin

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