Catastrophizing worsens low back pain

Catastrophizing and fear-avoidance beliefs may be linked to poor treatment outcomes in those with low back pain.

Higher pain, disability noted among patients that catastrophize
Higher pain, disability noted among patients that catastrophize

HealthDay News -- For patients with low back pain, catastrophizing may be associated with pain and disability, and fear-avoidance beliefs correlate with poor treatment outcomes, according to two reviews published in The Spine Journal.

Maria M. Wertli, MD, from the University of Zurich, and colleagues conducted a systematic review to examine the prognostic importance of catastrophizing as a coping strategy in patients with chronic low back pain. Data were included from 19 publications based on 16 studies. 

Two of the four studies that assessed work-related outcomes found a correlation between catastrophizing and work status, the researchers found. Catastrophizing was found to be associated with pain and disability at follow-up in most of the studies that examined self-reported outcome measures. Outcome was worse for high versus low catastrophizers.

In a second study, Wertli and colleagues conducted a systematic review to examine the influence of FABs on treatment outcomes in patients with low back pain. Data were included for 17 randomized controlled trials, of which five were high quality.

High fear-avoidance beliefs (FABs) correlated with more pain and/or disability and less return to work, the researchers found. Less pain and disability at follow-up was seen in association with a decrease in FAB values during treatment.

"Evidence suggests that FABs are associated with poor treatment outcome in patients with low back pain of less than six months, and thus early treatment, including interventions to reduce FABs, may avoid delayed recovery and chronicity," Wertli and colleagues wrote.

References

  1. Wertli MM et al. Spine J. 2014; 14(11): 2639-2657.
  2. Wertli MM et al. Spine J. 2014; 14(11): 2658-2678.

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