Influence of central aspects of pain on self-management in people with chronic low back pain

Georgopoulos, Vasileios; McWilliams, Daniel F.; Hendrick, Paul; Walsh, David A.

Abstract

Objective: This observational study investigated whether central aspects of pain are associated with self-management domains in individuals with chronic low back pain (CLBP) undertaking a pain management program. Methods: Individuals with CLBP provided pain sensitivity and self-management data at baseline (n = 97) and 3-months (n = 87). Pressure pain detection threshold (PPT) at the forearm, temporal summation (TS) and conditioned pain modulation (CPM), Widespread Pain Index (WPI), and a Central Aspects of Pain factor (CAPf) were considered as central aspects of pain. Self-management was measured using the 8 domains of the Health Education Impact Questionnaire, as well as Pain Self Efficacy and Health Care Utilisation questionnaires. Results: PPT, CPM, WPI and CAPf predicted worse performance in several self-management domains at 3-months (r = 0.21 to 0.54, p < 0.05 overall). In multivariable regression models (adjusted for baseline scores of self-management, depression, catastrophization, pain and fatigue) low PPT, high TS, and high CAPf at baseline predicted poorer self-management at 3 months (R2 =0.14 to 0.52, β = −0.37 to 0.35, p < 0.05). Conclusions: Central aspects of pain are associated with impaired self-management, over and above effects of pain intensity, fatigue, depression and catastrophizing. Practice implications: Treatments that target central aspects of pain might help improve self-management in people with CLBP.

Citation

Georgopoulos, V., McWilliams, D. F., Hendrick, P., & Walsh, D. A. (2024). Influence of central aspects of pain on self-management in people with chronic low back pain. Patient Education and Counseling, 121, Article 108109. https://doi.org/10.1016/j.pec.2023.108109

• Journal Article Type: Article
• Acceptance Date: Dec 10, 2023
• Online Publication Date: Dec 13, 2023
• Publication Date: 2024-04
• Deposit Date: Dec 15, 2023
• Publicly Available Date: Dec 14, 2024
• Journal: Patient Education and Counseling
• Print ISSN: 0738-3991
• Electronic ISSN: 1873-5134
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 121
• Article Number: 108109
• DOI: https://doi.org/10.1016/j.pec.2023.108109
• Keywords: General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/24149516
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0738399123004901?via%3Dihub
• Additional Information: This article is maintained by: Elsevier; Article Title: Influence of central aspects of pain on self-management in people with chronic low back pain; Journal Title: Patient Education and Counseling; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.pec.2023.108109; Content Type: article; Copyright: © 2023 The Author(s). Published by Elsevier B.V.