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Predictors of Pain Intensity and Disability After Minor Hand Surgery
Abstract
Purpose To test the null hypothesis that there is no relationship between coping mechanisms and depression measured before surgery, and pain intensity and disability after surgery, as assessed at the time of suture removal.Methods A total of 120 patients (39 electing surgery for carpal tunnel syndrome, 65 for trigger finger, and 16 for a benign tumor) completed questionnaires measuring depression, pain self-efficacy (confidence that one can perform various activities despite pain), pain anxiety (fear and anxiety in response to pain sensations), and pain catastrophizing (maladaptive cognitive activities such as pain-related rumination, magnification, and helplessness) before surgery. Before the surgery and at the time of suture removal (10 to 14 days after surgery) participants completed the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) and a numerical pain intensity rating scale.Results At the time of suture removal, there was a significant correlation between pain intensity and depression (r = 0.45, p<.001), pain catastrophizing (r = 0.41, p<.001), pain anxiety (r = 0.32, p<.01), and self-efficacy (r = -0.29, p<.01). Disability correlated with self-efficacy (r = -0.34; p<.001) and depression (r = 0.49; p<.001), but not with pain anxiety and catastrophizing (p>.05). In multivariate analyses, depression was the sole predictor of both disability and pain intensity and accounted for 26% of the variance in DASH scores and 25% of the variance in pain intensity, after removing the influence of preoperative DASH and diagnosis, which accounted for 14% variance.Conclusions Psychosocial factors, especially depression, explain a notable proportion of the variation in pain intensity and disability after minor hand surgery.Type of study/level of evidence Prognostic I.
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“In addition to pathophysiology, psychosocial factors can predict disability in individuals with hand and upper limb injuries [5,6].”
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Self-citation
Metadata
- Authors
- Vranceanu, A.-M., Jupiter, J. B., Mudgal, C. S., & Ring, D.
- Affiliations
- Massachusetts General Hospital (US)
- Corresponding author
- Ring, David
- Venue
- The Journal of Hand Surgery
- Publisher
- Elsevier BV
- Published
- 2010-06
- Volume
- 35
- Issue
- 6
- Pages
- 956-960
- ISSN
- 0363-5023 (ISSN-L)
- OpenAlex
- W2123809604
- Cited by
- 216
- References
- 37
- Citations by year
- 2026: 7 · 2025: 2 · 2024: 9 · 2023: 18 · 2022: 13 · 2021: 17 · 2020: 16 · 2019: 14 · 2018: 25 · 2017: 11 · 2016: 19 · 2015: 15 · 2014: 22 · 2013: 13 · 2012: 9
- FWCI
- 9.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The Journal Of Hand Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Orthopedic Surgery and Rehabilitation
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- postoperative pain, hand surgery, depression, pain catastrophizing, pain-related anxiety, pain self-efficacy, disability, carpal tunnel syndrome, trigger finger, psychosocial factors, prognostic factors, DASH questionnaire
- MeSH terms
- Adaptation, Psychological, Carpal Tunnel Syndrome, Humans, Pain Measurement, Postoperative Pain, Surveys and Questionnaires, Soft Tissue Neoplasms, Trigger Finger Disorder
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