Cited by 102Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationPain Management and Treatment

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Differential predictors of the long-term levels of pain intensity, work disability, healthcare use, and medication use in a sample of workers' compensation claimants

Wideman, Timothy H., Sullivan, Michael J.L.·2011·Pain

DOI 10.1016/j.pain.2010.10.044

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Abstract

The fear avoidance model of pain (FAM) conceptualizes pain catastrophizing as the cognitive antecedent of pain-related fear, and pain-related fear as the emotional antecedent of depression and disability. The FAM is essentially one of mediation whereby pain-related fear becomes the process by which depression or disability ensue. However, emerging literature suggests that pain catastrophizing, pain-related fear, and depression might be at least partially distinct in their prediction of different pain-related outcomes. The primary purpose of the present study was to evaluate whether psychological factors in the FAM (pain catastrophizing, pain-related fear, and depression) differentially predict long-term pain-related outcomes. Toward this objective, we conducted a prospective study using a cohort of 202 individuals with subacute work-related musculoskeletal injuries. Participants completed a 7-week physical therapy program with a functional rehabilitation orientation. Posttreatment measures of fear of movement, pain catastrophizing, depression, and pain self-efficacy were used to predict the persistence of pain symptoms, healthcare use, medication use, and return-to-work at one-year follow-up. Results from hierarchical linear and logistic regression analyses revealed that pain catastrophizing and fear of movement act as differential predictors of long-term pain-related outcomes. Specifically, we found unique relationships between pain catastrophizing and long-term pain intensity, and fear of movement and long-term work disability. After controlling for pain intensity and FAM variables, pain self-efficacy was shown to be a unique predictor of medication use. Implications for the FAM and the clinical management of musculoskeletal pain conditions are discussed. Unique relationships were found between pain catastrophizing and long-term pain intensity, between fear of movement and long-term work disability, and between pain self-efficacy and medication use at one-year follow-up.

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Authors: Wideman, T. H., & Sullivan, M. J. L.
Affiliations: McGill University (CA)
ORCID: Wideman, Timothy H.
Sullivan, Michael J.L.
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2011-02
Volume: 152
Issue: 2
Pages: 376-383
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/j.pain.2010.10.044
OpenAlex: W2108495176
Cited by: 102
References: 39
Citations by year: 2025: 3 · 2024: 4 · 2023: 1 · 2022: 4 · 2021: 8 · 2020: 8 · 2019: 5 · 2018: 8 · 2017: 11 · 2016: 9 · 2015: 6 · 2014: 11 · 2013: 16 · 2012: 6
FWCI: 5.64
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Funders: Canadian Institutes for Health Research
Fonds de la Recherche en Santé du Québec (FRSQ)
Institut de Recherche Robert-Sauvé en Santé et en Securité du Travail (IRSST)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: pain catastrophizing, kinesiophobia, fear of pain, depression, pain self-efficacy, work-related musculoskeletal disorders, return to work, work disability, pain intensity, health care utilization, medication use, physiotherapy, functional rehabilitation
MeSH terms: Adolescent, Adult, Aged, Canada, Depression, Fear, Female, Forecasting, Humans, Male, Middle Aged, Musculoskeletal Diseases, Pain, Prospective Studies, Workers' Compensation, Cohort Studies, Young Adult, Catastrophization

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Differential predictors of the long-term levels of pain intensity, work disability, healthcare use, and medication use in a sample of workers' compensation claimants

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