The DOI matches its Crossref record; 161 of the 161 references it cites were found in a registry or an index.
Pain-Related Fear, Pain Intensity and Function in Individuals With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis
Open accessAbstract
Pain-related fear is considered a strong psychological predictor for both chronic pain and disability. The aims of this study were to systematically review and critically appraise the concurrent association and the predictive value of pain-related fear affecting both pain intensity and disability in individuals with chronic musculoskeletal pain (MSK). PubMed, AMED, CINAHL, PsycINFO, PubPsych, and the grey literature were searched from inception to January 2019. Observational studies reporting cross-sectional and longitudinal associations between pain-related fear and pain intensity and/or disability were included. The GRADE criteria judged whether the overall quality and strength of the evidence was high or low in terms of risk of bias, inconsistency, indirectness, imprecision and publication bias. Seventy observational studies (97% cross-sectional) were included with a total sample of 15,623 individuals (63.56% females) with chronic MSK. Pain-related fear is composed of fear of pain, pain-related anxiety, and fear-avoidance beliefs. Greater levels of fear of pain, pain-related anxiety, and fear-avoidance beliefs were significantly associated with greater pain intensity and disability. However, the quality and strength of the evidence was very low owing to the imprecision of results, risk of bias, indirectness, and publication bias were common across the included studies. Despite these limitations, these findings highlight the potential role that pain-related fear may play in chronic MSK and disability. The field would benefit from research using higher quality studies and longitudinal designs. PERSPECTIVE: This article presents promising results about the concurrent association between pain-related fear and both pain intensity and disability in individuals with chronic MSK. Nevertheless, the overall quality and strength of the evidence was very low in terms of risk of bias, indirectness, imprecision, and publication bias. Thus, the findings should be taken with caution, and further research is needed. PROSPERO: CRD42018082018.
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“These models identify key psychological constructs (yellow flags) such as pain catastrophizing, kinesiophobia, pain anxiety, depression, pain avoidance and low pain self-efficacy which are associated with poor long-term MSK health outcomes (Leeuw et al., 2007;Lentz et al., 2016;Martinez-Calderon et al., 2019;Stearns et al., 2021;Van Wyngaarden et al., 2019).”
From Beyond yellow flags: The Big‐Five personality traits and psychologically informed musculoskeletal rehabilitation. (2023) · cites this paper as Martinez-Calderon et al., 2019
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Metadata
- Authors
- Martinez-Calderon, J., Flores-Cortes, M., Morales-Asencio, J. M., & Luque-Suarez, A.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2019-12
- Volume
- 20
- Issue
- 12
- Pages
- 1394-1415
- ISSN
- 1526-5900 (ISSN-L)
- OpenAlex
- W2944252725
- Cited by
- 141
- References
- 161
- Citations by year
- 2026: 14 · 2025: 31 · 2024: 21 · 2023: 25 · 2022: 18 · 2021: 15 · 2020: 15 · 2019: 2
- FWCI
- 1.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Universidad de Málaga
- Topics
- 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
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Keywords
- fear of pain, chronic musculoskeletal pain, pain intensity, disability, pain-related anxiety, fear-avoidance beliefs
- MeSH terms
- Fear, Humans, Male, Chronic Pain, Musculoskeletal Pain, Observational Studies as Topic
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