Catastrophizing can predict low back pain, disability
Maria M. Wertli, M.D., from the University of Zurich, and colleagues conducted a systematic literature review to examine the effect of catastrophizing on treatment efficacy and outcome in patients treated for low back pain. Eleven studies, comprising 2,269 patients, were included in analyses.
Due to heterogeneity in study settings, treatments, outcomes, and patient populations, meta-analyses were impeded. The researchers found that catastrophizing at baseline predicted disability and pain at follow-up in four and two studies, respectively. In three studies there was no evidence of a predictive effect for catastrophizing. In all five studies that assessed the impact of a decrease in catastrophizing during treatment, a moderating effect was found, with a greater decrease linked to better outcome. There was no effect seen in most studies that assessed the moderating effects on treatment efficacy, although most studies did not focus on a direct interaction between the treatment and catastrophizing thoughts. The influence of catastrophizing on work-related outcomes, including return to work, was not investigated in any of the studies.
"The presence of catastrophizing should be considered in patients with persisting back pain," the authors write.
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