Early post-immobilization pain at rest, movement evoked pain, and their ratio as potential predictors of pain and disability at six- and 12-months after distal radius fracture.

The data were collected for a cohort study and retrieved later for this analysis. Fracture type, surgical management, and pain medication information were not available, so the models could not account for them. The nature of rehabilitation services received was not recorded, so treatment differences could not be controlled. Psychosomatic or behavioral factors were not included, even though the authors note they can affect recovery after distal radius fracture. No sample size calculation was done because the analysis was retrospective. The ratio score was made by dividing two ordinal pain items and had a small range, so it may not measure irritability well. Participants came from one centre, and the data were collected between 1996 and 2009.

Do not use the ratio of movement-evoked pain to pain at rest as a clinical irritability score. The ratio did not accurately classify later pain or disability, and the authors advise evaluating pain at rest and movement-evoked pain separately.