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Pain-related fear and functional recovery in sciatica: results from a 2-year observational study

Authors Haugen AJ, Grøvle L, Brox JI, Natvig B, Grotle M

Received 15 June 2016

Accepted for publication 3 August 2016

Published 31 October 2016 Volume 2016:9 Pages 925—931


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Michael E Schatman

AJ Haugen,1 L Grøvle,1 JI Brox,2 B Natvig,3 M Grotle4

1Department of Rheumatology, Østfold Hospital Trust, Grålum, 2Department of Physical Medicine and Rehabilitation, Division for Neuroscience, Oslo University Hospital, 3Department of General Practice, Institute of Health and Society, University of Oslo, 4FORMI (Communication Unit for Musculoskeletal Disorders), Division of Neuroscience, Oslo University Hospital, Oslo, Norway

Objectives: The purpose of this study was to explore the associations between pain-related fear, pain disability, and self-perceived recovery among patients with sciatica and disk herniation followed up for 2 years.
Patients and methods: Pain-related fear was measured by the Tampa Scale for Kinesiophobia (TSK) and the Fear-Avoidance Beliefs Questionnaire-Physical Activity (FABQ-PA) subscale. Disability was measured by the Maine–Seattle Back Questionnaire. At 2 years, patients reported their sciatica/back problem on a global change scale ranging from completely gone to much worse. No specific interventions regarding pain-related fear were provided.
Results: Complete data were obtained for 372 patients. During follow-up, most patients improved. In those who at 2 years were fully recovered (n=66), pain-related fear decreased substantially. In those who did not improve (n=50), pain-related fear remained high. Baseline levels of pain-related fear did not differ significantly between those who were fully recovered and the rest of the cohort. In the total cohort, the correlation coefficients between the 0–2-year change in disability and the changes in the TSK and the FABQ-PA were 0.33 and 0.38, respectively. In the adjusted regression models, the 0–2-year change in pain-related disability explained 15% of the variance in the change in both questionnaires.
Conclusion: Pain-related fear decreased substantially in patients who recovered from sciatica and remained high in those who did not improve. Generally, the TSK and the FABQ-PA yielded similar results. To our knowledge, this is the first study that has assessed pain-related fear in patients who recover from sciatica.

Keywords: kinesiophobia, fear-avoidance, recovery

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