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Cited by 821Musculoskeletal pain and rehabilitationPain Management and TreatmentPsychosomatic Disorders and Their Treatments

Impact of psychological factors in the experience of pain

Linton, Steven J., Shaw, William S.·2011·Physical Therapy
DOI 10.2522/ptj.20100330
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Abstract

This article reviews the role of psychological factors in the development of persistent pain and disability, with a focus on how basic psychological processes have been incorporated into theoretical models that have implications for physical therapy. To this end, the key psychological factors associated with the experience of pain are summarized, and an overview of how they have been integrated into the major models of pain and disability in the scientific literature is presented. Pain has clear emotional and behavioral consequences that influence the development of persistent problems and the outcome of treatment. Yet, these psychological factors are not routinely assessed in physical therapy clinics, nor are they sufficiently utilized to enhance treatment. Based on a review of the scientific evidence, a set of 10 principles that have likely implications for clinical practice is offered. Because psychological processes have an influence on both the experience of pain and the treatment outcome, the integration of psychological principles into physical therapy treatment would seem to have potential to enhance outcomes.

Integrity signals

Registry

Crossref · 10.2522/ptj.20100330

Cites

54 of 54 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 54 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    People with a psychiatric history, depressed mood, major life adversity, or high stress are at greater risk of transitioning to chronic and disabling low back pain.

    “there is considerable evidence that individuals with a psychiatric history, with depressed mood, with major life adversity, or reporting high levels of stress are at greater risk of transitioning to chronic and disabling LBP.24,32,59,60”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [24] 2000, A review of psychological risk factors in back and neck pain, Spine (Phila Pa 1976) source

      Not checked in the free run.

    • cites [32] 2002, A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain, Spine (Phila Pa 1976) source

      Not checked in the free run.

    • cites [59] 2002, Determinants of occupational disability following a low back injury: a critical review of the literature, J Occup Rehabil source

      Not checked in the free run.

    • cites [60] 2004

      Not checked in the free run.

  • Findingcitation

    Three pain beliefs shown to put patients at greatest risk of poor prognosis are pain catastrophizing, fear avoidance, and poor expectations for recovery.

    “Three pain beliefs that have been shown to put patients at greatest risk of a poor prognosis are pain catastrophizing (an exaggerated, negative interpretation of pain), fear avoidance (a belief that all activity should be avoided to reduce”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] the “ Decade of the Flags” Working Group, 2011, Early identification and management of psychological risk factors (“yellow flags”) in patients with low back pain: a reappraisal, Phys Ther source

      Not checked in the free run.

  • Premisecitation

    Beliefs and attitudes are linked to the development of persistent pain and disability.

    “Several attitudes and beliefs have been found to be related to the development of persistent pain and disability.14,15”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [14] 2010, How important are back pain beliefs and expectations for satisfactory recovery from back pain?, Best Pract Res Clin Rheumatol source

      Not checked in the free run.

    • cites [15] 2008, Exposure in vivo versus operant graded activity in chronic low back pain patients: results of a randomized controlled trial, Pain source

      Not checked in the free run.

  • Premisecitation

    Efforts to suppress pain-related thoughts can intensify the experience of pain.

    “Indeed, the paradox is that attempting to suppress thoughts about pain actually increases the pain experience.12”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] 2008

      Not checked in the free run.

  • Premisecitation

    About 10% of acute low back pain cases directly become persistent and disabling for a long time.

    “Although many acute low back pain (LBP) problems resolve, a minority of people (ϳ10%) directly develop a persistent problem that disables them for a long period of time.4,5”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [4] 2002

      Not checked in the free run.

    • cites [5] 1998

      Not checked in the free run.

  • May combine two claims. 21
  • Classified as probably not a substantial claim. 14

  • May combine two claims.

    Findingcitation

    In patients with chronic pain, pain-related acceptance leads to less emotional distress and higher physical functioning.

    “Recent studies of patients with chronic pain have suggested that pain-related acceptance leads to less emotional distress and higher physical functioning.46 -48”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [46] 2003, Coping or acceptance: what to do about chronic pain?, Pain source

      Not checked in the free run.

    • cites [47] 1998, Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain, Pain source

      Not checked in the free run.

    • cites [48] 1999, Behavioral dimensions of adjustment in persons with chronic pain: pain-related anxiety and acceptance, Pain source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The threat value of a noxious stimulus guides awareness, so greater threat leads to more attention.

    “If pain is considered a “threat,” then the threat value of the (noxious) stimulus helps to steer awareness: the greater the threat, the more attention given.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Attention to a noxious stimulus is a prerequisite for pain perception.

  • May combine two claims.

    Premisecitation

    Negative affect is strongly linked to poor treatment outcome and to disability from low back pain.

    “Indeed, negative affect is strongly associated with poor treatment outcome, as well as the development of disability from LBP. 12,24”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [12] 2008

      Not checked in the free run.

    • cites [24] 2000, A review of psychological risk factors in back and neck pain, Spine (Phila Pa 1976) source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Psychological factors may affect both acute pain and the later development of chronic pain and disability.

    “we emphasize how psychological factors may contribute not only to the experience of acute pain but also to the development of chronic pain and disability over time.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Psychological processes are highly intertwined and operate together as a system.

  • May combine two claims.

    Interpretationnone given

    Psychological factors are not routinely assessed in physical therapy clinics and are not sufficiently used to improve treatment.

    “Yet, these psychological factors are not routinely assessed in physical therapy clinics, nor are they sufficiently utilized to enhance treatment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Depression in a pain condition is associated with greater pain intensity and is a strong risk factor for disability.

    “The presence of depression in a pain condition is associated with higher levels of pain intensity and is a potent risk factor for disability.27,29”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [27] 2003, Depression and pain comorbidity: a literature review, Arch Intern Med source

      Not checked in the free run.

    • cites [29] Depression and pain: what is the link?, Scand J Pain

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Clinicians found many listed factors hard to manage in practice, and these did not align with the evidence-based factors in that article.

    “many of the factors listed by clinicians were difficult for them to address (eg, economic, drug abuse, or marital issues) in the clinic and did not match the evidence-based factors included in that article. 2”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2] 2004, Do physical therapists recognise established risk factors: Swedish physical therapists' evaluation in comparison to guidelines, Physiotherapy source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Among primary-care physical therapists, 63% knew psychological factors were important, while only 47% said they knew how to apply them in clinical care.

    “although 63% of physical therapists in a primary care setting were aware of the importance of psychological factors, only 47% reported knowledge of utilizing them clinically.3”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] 2005, Do evidence-based guidelines have an impact in primary care: a cross-sectional study of Swedish physicians and physiotherapists, Spine (Phila Pa 1976) source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Pain catastrophizing is linked to problems that impede recovery, complicate treatment, and raise the risk of persistent pain and disability.

    “Not surprisingly, pain catastrophizing is associated with a variety of problems that hinder recovery, making treatment more difficult and increasing the risk of developing persistent pain and disability.6,9,22”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [6] the “ Decade of the Flags” Working Group, 2011, Early identification and management of psychological risk factors (“yellow flags”) in patients with low back pain: a reappraisal, Phys Ther source

      Not checked in the free run.

    • cites [9] 2007, The fear-avoidance model of musculoskeletal pain: current state of scientific evidence, J Behav Med source

      Not checked in the free run.

    • cites [22] 2006, Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors?, J Occup Rehabil source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Most physical therapists know that psychological factors matter and try to use that awareness in practice.

    “A majority of physical therapists are aware of the importance of psychological factors and attempt to utilize this awareness in their practice.2,3”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [2] 2004, Do physical therapists recognise established risk factors: Swedish physical therapists' evaluation in comparison to guidelines, Physiotherapy source

      Not checked in the free run.

    • cites [3] 2005, Do evidence-based guidelines have an impact in primary care: a cross-sectional study of Swedish physicians and physiotherapists, Spine (Phila Pa 1976) source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    The biopsychosocial view of pain is widely accepted, but how psychological factors fit, especially in clinical settings, remains unclear.

    “To date, there has been broad recognition of the importance of a biopsychosocial view of pain, but a lack of clarity in how the psychological factors actually fit in, not least in clinical situations.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Resting or taking analgesics may help in acute pain but may promote long-term problems.

    “For example, Fordyce 36 suggested that although resting or taking analgesics may be a good coping strategy in the acute phase, these behaviors might actually facilitate the development of long-term problems.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [36] 1976

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    When multiple attempts to get rid of pain fail, worries are further reinforced, and patients become stuck in an endless loop of increasing worries and failed problem-solving attempts.

    “When multiple attempts to get rid of pain fail, worries are further reinforced, and patients are stuck in an endless loop of increasing worries and failed problem-solving attempts to alleviate pain.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In the fear-avoidance model, fear of pain arises from interpreting pain as threatening, affects attention through hypervigilance, and leads to avoidance, disability, disuse, and depression.

    “Fear of pain develops as a result of a cognitive interpretation of pain as threatening (pain catastrophizing), and this fear affects attention processes (hypervigilance) and leads to avoidance behaviors, followed by disability, disuse, and depression.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [37][38][39]

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Negative affectivity and threatening illness information can fuel catastrophic thoughts about pain.

    “Both negative affectivity (a tendency to see the cup as “half empty” rather than “half full”) and threatening types of illness information can help to fuel catastrophic thoughts about pain.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Worrying about pain is part of a natural problem-solving strategy, but in chronic pain it can have negative long-term consequences.

    “Thus, worrying about pain and its implications is part of a natural-born problem-solving strategy, but one that, at least in the case of chronic pain, can have negative long-term”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49] 2007, Worry and chronic pain: a misdirected problem solving model, Pain source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Persistent pain repeatedly interrupts attention, fuels worries about negative consequences, produces hypervigilance to pain, and produces repeated efforts to alleviate pain even when no solution is believed to exist.

    “This model explains why persistent pain repeatedly interrupts attention, fuels worries about negative consequences, produces hypervigilance to pain, and produces repeated efforts to alleviate pain, even when there is no belief that a solution exists.8,50,51”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [8] 1999, Pain demands attention: a cognitive-affective model of the interruptive function of pain, Psychol Bull source

      Not checked in the free run.

    • cites [50] 2006, Worrying about chronic pain: an examination of worry and problem solving in adults who identify as chronic pain sufferers, Pain source

      Not checked in the free run.

    • cites [51] 2001, Worry and chronic pain patients: a description and analysis of individual differences, Eur J Pain source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Active coping promotes confidence or self-efficacy for dealing with pain, and that self-efficacy is associated with improved function and wellbeing.

    “A tenet of this model is that active coping promotes a sense of con-fidence, or “self-efficacy,” for dealing with pain that is associated with improved function and wellbeing.52,53”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [52] 2011, Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain, Eur J Pain source

      Not checked in the free run.

    • cites [53] 2010, Impact of the interaction between self-efficacy, symptoms and catastrophising on disability, quality of life and health with chronic pain patients, Disabil Rehabil source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning
    § Impact of Psychological Factors in the Experience of Pain

    Over time, fear of pain leads to musculoskeletal deconditioning, lower pain tolerance, and fewer attempts to overcome functional limits.

    “Over time, fear of pain results in musculoskeletal deconditioning, reduced pain tolerance, and fewer attempts to overcome functional limitations.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    Effective strategies for coping with persistent, recurrent, or chronic pain are very different from those for managing acute pain.

    “Effective strategies for coping with persistent, recurrent, or chronic pain are very different from those for managing acute pain”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Pain that persists beyond a few weeks can lead to emotional and behavioral consequences that are deleterious to pain recovery and functional rehabilitation.

    “pain that persists beyond a few weeks can lead to emotional and behavioral consequences that are deleterious to pain recovery and functional rehabilitation.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Persistent pain naturally leads to emotional and behavioral consequences for the majority of individuals.

    “Persistent pain naturally leads to emotional and behavioral consequences for the majority of individuals.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    Catastrophic thinking about pain is an important marker for the development of long-term pain problems as well as for poor treatment outcome.

    “Catastrophic thinking about pain is an important marker for the development of long-term pain problems as well as for poor treatment outcome.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Personal acceptance and commitment to self-manage pain problems are associated with better pain outcomes.

    “Personal acceptance and commitment to selfmanage pain problems are associated with better pain outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    With proper instruction and support, psychological interventions can improve pain management outcomes.

    “With proper instruction and support, psychological interventions can improve pain management outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Psychosocial aspects of the workplace may represent barriers for returning to work while pain problems linger.

    “Psychosocial aspects of the workplace may represent barriers for returning to work while pain problems linger.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Clients who are depressed or have a history of depression may have more difficulty dealing with pain.

    “Clients who are depressed or have a history of depression may have more difficulty dealing with pain.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Personal expectations about the course of pain recovery and treatment benefits are associated with pain outcomes.

    “Personal expectations about the course of pain recovery and treatment benefits are associated with pain outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Individuals hold very different attitudes and beliefs about the origins of pain, the seriousness of pain, and how to react to pain.

    “Individuals hold very different attitudes and beliefs about the origins of pain, the seriousness of pain, and how to react to pain.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Reframing the problem toward more functional goals and away from pain relief or biomedical explanations may help redirect problem-solving efforts that are more likely to be successful.

    “Instead, a reframing of the problem toward more-functional goals and away from pain relief (or biomedical explanations of pain) may help to redirect problem-solving efforts that are more likely to be successful.49”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49] 2007, Worry and chronic pain: a misdirected problem solving model, Pain source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    Persistent pain problems can lead to hypervigilance and avoidance, but simple distraction techniques are not enough to counter these behaviors.

    “Persistent pain problems can lead to hypervigilance and avoidance, but simple distraction techniques are not enough to counter these behaviors.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Psychological theories and models about pain have provided a better understanding of cognitive, emotional, and behavioral manifestations of pain.

    “Psychological theories and models about pain have provided a better understanding of cognitive, emotional, and behavioral manifestations of pain”
    Quote in the paperNot a substantial claim
32 of 32

  • The paper relies on this without support.

    Psychological processes are highly intertwined and operate together as a system.

    “A basic theme is that the psychological processes are highly intertwined and function together as a system.”

  • The paper relies on this without support.

    Attention to a noxious stimulus is a prerequisite for pain perception.

    “An obvious prerequisite for pain perception is that our attention is directed toward the noxious stimulus.”

  • The paper relies on this without support.

    Pain is a subjective experience shaped by previous experience.

    “pain is a subjective experience, and although it is certainly related to physiological processes, how individuals react to a new episode of pain is shaped and influenced by previous experience.”

  • The authors state this as an assumption.

    The influence of psychological factors can be portrayed as a sequence from attention through cognitive processing, appraisal, interpretation, and pain behavior.

    “In our presentation, we attempt to portray the influence of psychological factors, as illustrated in Figure 1, as a sequence of processes, starting with initial awareness of the noxious stimulus, then cognitive processing, appraisal, and interpretation that leads people to act on their pain (ie, their pain behavior).7”
    “Although we present this as a sequence for understanding, we are aware that this is a model, and much more work is needed to fully describe these processes.”

  • The paper relies on this without support.

    Low self-efficacy and the feeling that pain is uncontrollable cause physical and psychological dysfunction.

    “The belief that a person is capable of coping with pain is directly related to self-management; low self-efficacy, with feelings that the pain is uncontrollable cause physical and psychological dysfunction.”

  • The paper relies on this without support.

    When low back pain occurs in someone already under significant psychological stress or with limited coping resources, pain may lead to greater functional limitations and emotional distress.

    “This model suggests that when LBP befalls an individual who is already under significant psychological stress or whose coping resources are already stretched thin, pain may result in more significant functional limitations and generate higher levels of emotional distress.”

  • The paper relies on this without support.

    Protective psychosocial factors buffer the emotional impact of pain, while distress and emotional dysregulation predispose to pain.

    “Protective psychosocial factors buffer the emotional impact of pain, whereas distress and emotional dysregulation predispose to pain”

  • The paper relies on this without support.

    Fluctuating pain reduces perceptions of control and mastery over pain.

    “Fluctuating pain reduces perceptions of control and mastery over pain”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The survey design relied on self-report metrics, which could introduce biases in the reporting of psychological distress and physical pain, given their known association, and can be dependent on the time of survey response.

    “Our survey design relied on self-report metrics, which could introduce biases in the reporting of psychological distress and physical pain, given their known association, and can be dependent on the time of survey response.56”

    From Mindful attention is inversely associated with pain via mediation by psychological distress in orthopedic patients. (2024) · cites this paper as [56]

    The “Emotions and their regulation” section links psychological distress with pain, reporting that depression is associated with higher pain intensity. The paper does not address whether self-report surveys introduce reporting bias or whether responses depend on the time of survey completion. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Pain beliefs like pain catastrophizing, fear of avoidance of work, and low expectations for recovery put patients at a poor prognosis.

    “Pain beliefs like pain catastrophizing (an exaggerated, negative interpretation of pain), fear of avoidance of work (a belief that all activities should be avoided to reduce pain), and low expectations for recovery put patients at a poor prognosis.[5]”

    From Mindfulness influences the psycho-social dimension of chronic pain: A randomized controlled clinical trial in Indian context (2023) · cites this paper as [5]

    The Conclusions and Implications section identifies catastrophizing and fear avoidance as beliefs associated with poor prognosis, and says expectations about recovery are associated with pain outcomes. The available passage does not establish that *low* recovery expectations specifically predict poor prognosis, or that fear avoidance is specifically avoidance of work rather than activity generally. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Despite a range of psychological factors being important in the genesis and persistence of chronic pain syndromes, they are not always routinely assessed in general practice or utilized to enhance treatment outcomes.

    “Despite a range of psychological factors being important in the genesis and persistence of CP syndromes, they are not always routinely assessed in general practice or utilized to enhance treatment outcomes.26”

    From <p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p> (2020) · cites this paper as [26]

  • Psychological processes influence the experience of pain and the treatment outcomes.

    “It is known that psychological processes influence the experience of pain and the treatment outcomes; therefore, there is a chance that integrating psychological approaches into physical therapy could enhance outcomes [45].”

    From 'A Mindful ACT'- testing the feasibility and acceptability of a brief psychosocial intervention designed to accompany osteopathy treatment for people who live with persistent pain. (2021) · cites this paper as [45]

Cites

Flagged first, then by citations

3 of the 57 references couldn’t be matched to a known paper.

Research works printed but not linked: 11

  1. 2004, Environmental and learning factors in the development of chronic pain and disability, 143
  2. 1998, The Back Pain Revolution
  3. 2005, Understanding Pain for Better Clinical Practice
  4. 1999, Assessment of pain beliefs, coping, and self-efficacy, 320
  5. 2004, Anxiety and its Disorders: The Nature and Treatment of Anxiety and Panic
  6. 2002, Depression and mood, 105
  7. Depression and pain: what is the link?, Scand J Pain
  8. 2002, Pain-related fear and its consequences in chronic musculoskeletal pain, 81
  9. 2001, Worry and chronic pain patients: a description and analysis of individual differences, Eur J Pain, 5, 309, 10.1053/eujp.2001.0252 · DOI · Paper page
  10. 2002, Concepts of treatment and prevention in musculoskeletal disorders, 47
  11. 1997, Guide to Assessing Psychosocial Yellow Flags in Acute Low Back Pain: Risk Factors for Long-term Disability and Work Loss

Cited by

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Related

Authors
Linton, S. J., & Shaw, W. S.
Affiliations
  • Örebro University (SE)
  • Liberty Mutual Research Institute for Safety (US)
Corresponding author
Linton, Steven J.
ORCID
Venue
Physical Therapy
Publisher
Oxford University Press (OUP)
Published
2011-05-01
Volume
91
Issue
5
Pages
700-711
ISSN
  • 0031-9023 (ISSN-L)
  • 1538-6724
DOI
10.2522/ptj.20100330
OpenAlex
W2104886205
Cited by
819
References
57
Citations by year
2026: 62 · 2025: 69 · 2024: 91 · 2023: 89 · 2022: 53 · 2021: 77 · 2020: 68 · 2019: 60 · 2018: 52 · 2017: 53 · 2016: 36 · 2015: 32 · 2014: 28 · 2013: 32 · 2012: 8
FWCI
17.57
Type
journal article
Language
en
Open access
closed
Locations
  • Physical Therapy (publishedVersion)
  • PubMed (publishedVersion)
  • The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
psychological factors, pain experience, chronic pain, disability, pain models, treatment principles
MeSH terms
Adaptation, Psychological, Attention, Cognition, Emotions, Persons with Disabilities, Humans, Learning, Models, Psychological, Pain, Pain Measurement, Psychophysiology, Health Behavior, Low Back Pain, Physical Therapy Modalities

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