Easing Emotional Distress Key to Neck Pain Treatment
A considerable amount of research has focused on assessing risk factors for developing long-term disability as a result of neck pain. However, knowledge is still lacking regarding disability in neck-pain patients receiving specialist treatment. A recent study sought to add to our understanding of the associations between patient characteristics and disability, specifically focusing on whether mental components such as emotional distress or fear of movement affected neck-pain disability.
The study involved 221 patients who experienced neck pain between 2007 and 2009 and were referred to a specialized neck and back pain clinic. Numerical rating scales were used to assess pain intensity, emotional distress, fear of movement, and self-rated disability.
The average neck disability was 41.9. According to the analysis, emotional distress explained 37% of the variance in the neck disability rating, while the pain intensity explained 12% and fear of movement accounted for 4%.
These results suggest that assessments of chronic neck pain should consider emotional distress, and that treatment strategies should include strategies intended to target emotional factors.
Earlier research has shown that high psychological distress can predict future neck pain in patients with whiplash injuries after an auto collision.
Fear of movement and psychological distress can also play a role in worsening symptoms of back pain. A recent study suggested that cognitive behavioral therapies and other conservative treatments may be more effective in reducing back pain than surgery.
Johansen JB, et al. The Determinants of Function and Disability in Neck Patients Referred to a Specialized Outpatient Clinic. Clinical Journal of Pain 2013; [Epub ahead of print].