PLoS ONE (Jan 2014)

Are pain-related fears mediators for reducing disability and pain in patients with complex regional pain syndrome type 1? An explorative analysis on pain exposure physical therapy.

  • Karlijn J Barnhoorn,
  • J Bart Staal,
  • Robert T M van Dongen,
  • Jan Paul M Frölke,
  • Frank P Klomp,
  • Henk van de Meent,
  • Han Samwel,
  • Maria W G Nijhuis-van der Sanden

DOI
https://doi.org/10.1371/journal.pone.0123008
Journal volume & issue
Vol. 10, no. 4
p. e0123008

Abstract

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To investigate whether pain-related fears are mediators for reducing disability and pain in patients with Complex Regional Pain Syndrome type 1 when treating with Pain Exposure Physical Therapy.An explorative secondary analysis of a randomised controlled trial.Fifty-six patients with Complex Regional Pain Syndrome type 1.The experimental group received Pain Exposure Physical Therapy in a maximum of five treatment sessions; the control group received conventional treatment following the Dutch multidisciplinary guideline.Levels of disability, pain, and pain-related fears (fear-avoidance beliefs, pain catastrophizing, and kinesiophobia) were measured at baseline and after 3, 6, and 9 months follow-up.The experimental group had a significantly larger decrease in disability of 7.77 points (95% CI 1.09 to 14.45) and in pain of 1.83 points (95% CI 0.44 to 3.23) over nine months than the control group. The potential mediators pain-related fears decreased significantly in both groups, but there were no significant differences between groups, which indicated that there was no mediation.The reduction of pain-related fears was comparable in both groups. We found no indication that pain-related fears mediate the larger reduction of disability and pain in patients with Complex Regional Pain Syndrome type 1 treated with Pain Exposure Physical Therapy compared to conventional treatment.International Clinical Trials Registry NCT00817128.