Changes in pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy mediate changes in pain intensity on disability in the treatment of chronic low back pain

Review written by Dr Sarah Haag info

Key Points

  1. There are multiple mediators that impact pain and disability outcomes.
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BACKGROUND & OBJECTIVE

Low back pain continues to be the leading cause of disability worldwide and is one of the most expensive healthcare problems. Persistent musculoskeletal pain has been reported to be greater than the annual costs of heart disease, cancer, and diabetes (1). A deeper understanding of the factors that impact pain and the factors that impact the development and persistence of low back pain is imperative.

The aim of this study was to examine if changes in pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy mediate changes in pain intensity on three measures of disability.

Persistent musculoskeletal pain has been reported to be greater than the annual costs of heart disease, cancer, and diabetes.
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Changes in pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy did mediate changes in pain intensity and disability.

METHODS

  • This study utilized data from a two-armed, randomized, controlled trial (2) which examined the effect of in-session exposure of feared movements in fear-avoidance treatment of chronic low back pain (CLBP) compared to fear-avoidance treatment only.
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