The prevalence of fear avoidance and pain catastrophising amongst patients with chronic neck pain.
Clare Cresswell, Mary L Galantino, Hellen Myezwa
PMID 32161823WHAT IT FOUND
About one in four patients with chronic neck pain reported fear of movement, and about one in six reported pain catastrophising.
These cognitive factors were linked to higher pain intensity and lower education, but not to how long the pain had lasted.
Key findings
01Clinically relevant levels of fear avoidance were found in 24.5% to 25.5% of participants, while pain catastrophising was found in 14.2% to 23.6%.
02Higher scores for both fear avoidance and pain catastrophising were associated with higher pain intensity, but no association was found between these cognitive factors and pain duration.
03Patients with primary or secondary education had significantly higher fear avoidance scores than those with tertiary education, but education level was not associated with pain catastrophising.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was conducted in private physiotherapy practices in Johannesburg, so results cannot be generalised to public health settings or lower socio-economic groups. The sample size was modest (106 participants), which may limit the detection of smaller associations. Self-selection bias may be present as the number of patients who declined participation was not recorded. The study did not account for potential confounders such as depression, anxiety, sleep quality, or previous trauma, which could influence fear avoidance and catastrophising. Participants were recruited from practices where English was likely the primary language, and the TSK-11 has not been validated in other South African languages, limiting applicability to non-English speakers.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that chronic neck pain is always driven by fear avoidance or catastrophising, as the majority of patients in this study did not report clinically relevant levels of these factors. Additionally, do not use pain duration as a proxy for psychological distress, as no association was found between how long the pain had lasted and these cognitive factors.