Article

An induced-pain paradigm has been used to examine risk factors for
the development of low back pain (LBP) during prolonged standing in back-healthy
people (standing paradigm). Previous studies that used induced-pain methods
suggest that pain intensity may be related to psychologic factors. It is not
currently known, however, whether pain intensity reported during the standing
paradigm is related to psychologic factors.
OBJECTIVE: To examine the
relationship between LBP symptom intensity and psychological factors (fear of
pain and pain catastrophizing) in back-healthy people who develop LBP during
prolonged standing. We hypothesized that symptom intensity during standing would
be positively related to initial levels of fear of pain and pain catastrophizing
in people who developed LBP during standing. DESIGN: Cross-sectional. SETTING:
Movement science research center at an academic medical center. PARTICIPANTS:
Fifty seven back-healthy participants. METHODS: Participants completed the Fear
of Pain Questionnaire-III (FPQ-III) and Pain Catastrophizing Scale (PCS) before a
2-hour standing protocol. Participants rated LBP intensity on a 100-mm visual
analogue scale (VAS) throughout standing and were classified as pain developers
(PDs) or nonpain developers (NPDs). Relationships between LBP intensity and
psychological measures were examined in PDs that did and did not have a >/=20 mm
maximum VAS score. MAIN OUTCOME MEASUREMENTS: FPQ-III and PCS total scores,
maximum and average VAS scores during standing. RESULTS: There were 24 (42%) PDs.
Five PDs reported a maximum VAS score >/=20 mm. For PDs with a maximum VAS score
<20 mm, correlations between average VAS scores and each psychological measure
were small and nonsignificant (FPQ-III: r = 0.16, P = .50; PCS: r = 0.27, P =
.26). For PDs with a maximum VAS score >/=20 mm, correlation between average VAS
scores and FPQ-III was large and significant (r = 0.91, P = .03), and large for
PCS but nonsignificant (r = 0.87, P = .06). CONCLUSION: These preliminary data
suggest that if pain exceeds a clinically meaningful threshold (20 mm) during
standing, pain intensity is related to psychological factors. Understanding
factors that modulate acute pain response can inform early intervention
strategies. LEVEL OF EVIDENCE: II.
CI - Copyright (c) 2016. Published by Elsevier Inc.

Langue : ANGLAIS