Catastrophizing-a prognostic factor for outcome in patients with low back pain: a systematic review
Open accessAbstract
Background context Psychological factors including catastrophizing thoughts are believed to influence the development of chronic low back pain (LBP).Purpose To assess the prognostic importance of catastrophizing as a coping strategy in patients with LBP.Study design This is a systematic review.Patient sample This study included patients with LBP.Outcome measures Work-related outcomes and perceived measures including return to work, pain, and disability.Methods In September 2012, the following databases were searched: BIOSIS, CINAHL, Cochrane Library, Embase, OTSeeker, PeDRO, PsycInfo, Medline, Scopus, and Web of Science. To ensure completeness of the search, a hand search and a search of bibliographies were conducted and all relevant references included. All observational studies investigating the prognostic value of catastrophizing in patients with LBP were eligible. Included were studies with 100 and more patients and follow-up of at least 3 months. Excluded were studies with poor methodological quality, short follow-up duration, and small sample size.Results A total of 1,473 references were retrieved, and 706 references remained after the removal of duplicates. For 77 references, the full text was assessed and 19 publications based on 16 studies were included. Of four studies that investigated work-related outcomes, two found catastrophizing to be associated with work status. Most studies that investigated self-reported outcome measures (n=8, 66%) found catastrophizing to be associated with pain and disability at follow-up in acute, subacute, and chronic LBP patients. In most studies that applied cutoff values, patients identified as high catastrophizers experienced a worse outcome compared with low catastrophizers (n=5, 83%).Conclusions There is some evidence that catastrophizing as a coping strategy might lead to delayed recovery. The influence of catastrophizing in patients with LBP is not fully established and should be further investigated. Of particular importance is the establishment of cutoff levels for identifying patients at risk.
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Patients with persistent pain show reductions in gray matter in the dorsolateral prefrontal cortex and insula.
“There are reductions in gray matter in the dorsolateral prefrontal cortex and insula among patients with persistent pain 381–383.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [383]
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- Authors
- Wertli, M. M., Eugster, R., Held, U., Steurer, J., Kofmehl, R., & Weiser, S.
- Affiliations
- University of Zurich (CH)
- New York University Langone Orthopedic Hospital (US)
- Corresponding author
- Wertli, Maria M.
- Venue
- The Spine Journal
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 14
- Issue
- 11
- Pages
- 2639-2657
- ISSN
- 1529-9430 (ISSN-L)
- OpenAlex
- W2097408032
- Cited by
- 363
- References
- 67
- Citations by year
- 2026: 22 · 2025: 31 · 2024: 25 · 2023: 36 · 2022: 38 · 2021: 37 · 2020: 43 · 2019: 20 · 2018: 26 · 2017: 28 · 2016: 30 · 2015: 22 · 2014: 4
- FWCI
- 3.59
- Type
- journal article
- Language
- en
- Open access
- green
- www.zora.uzh.ch
- Licence
- Locations
- The Spine Journal (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Keywords
- catastrophizing, chronic low back pain, coping strategies, prognostic factors, return to work, disability, pain intensity, psychological factors
- MeSH terms
- Adaptation, Psychological, Persons with Disabilities, Humans, Prognosis, Low Back Pain, Recovery of Function, Catastrophization, Return to Work
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