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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.

Authors

Paul Hendrick

DAVID WALSH david.walsh@nottingham.ac.uk
Professor of Rheumatology



Contributors

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.

Journal Article Type Article
Acceptance Date Dec 10, 2023
Online Publication Date Dec 13, 2023
Publication Date Dec 13, 2023
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.