Cognitive-behavioural treatment for subacute and chronic neck pain

Monticone, Marco; Cedraschi, Christine; Ambrosini, Emilia; Rocca, Barbara; Fiorentini, Roberta; Restelli, Maddalena; Gianola, Silvia; Ferrante, Simona; Zanoli, Gustavo; Moja, Lorenzo

doi:10.1002/14651858.cd010664.pub2

Cited by 67 publications

(36 citation statements)

References 98 publications

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“…This may not be so surprising because our behavioral approach was based on Cognitive Behavioural Therapy (CBT) principles, and a recent review of CBT treatment on chronic pain patients [32] concluded that CBT in addition to another interventions did not result in significantly better results. Moreover, the review showed only evidence for a short-time effect.…”

Section: Discussionmentioning

confidence: 99%

The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders

et al. 2016

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Background:To investigate the effect of neck-specific exercise with (NSEB) or without (NSE) a behavioural approach and prescribed physical activity (PPA) on general pain disability and psychological factors in chronic whiplash-associated disorders (WAD), grade 2 and 3, with a 2-year follow-up.Methods:A randomized controlled multi-centre study of 3 exercise interventions (NSE, NSEB or PPA) including a 2-year follow-up. A total of 216 volunteers with chronic WAD were recruited and 194 were analyzed, mean age 40.4 (Standard Deviation [SD] 11.4). Measures of general pain disability, pain catastrophizing, anxiety and depression, and kinesiophobia were evaluated at baseline, and 3, 6, 12 and 24 months with linear mixed models.Results:General pain disability decreased by 28% in the NSEB group from baseline to 3 months (P < 0.001) and the improvements in disability were maintained over time (6, 12 and 24 months P < 0.01) compared to the NSE (P > 0.42) and PPA groups (P > 0.43). Pain catastrophizing decreased in the NSE group from baseline to 6 and 12 months (P < 0.01) and in the NSEB group from baseline to 3 and 24 months (P < 0.01) compared to the PPA group (P > 0.82) that showed no change over time. The NSE group improved in kinesiophobia over time from baseline to12 months (P < 0.01) compared to the NSEB (P = 0.052) and the PPA groups (P > 0.74). Anxiety decreased over time from baseline to 12 and 24 months in the NSE group (P > 0.02), but not in the NSEB (P > 0.25) or the PPA (P > 0.50) groups. The PPA had no effect on general disability or any of the measured psychological factors.Conclusion:This randomised controlled trial with a 2-year follow-up shows that physiotherapist-led neck-specific exercise with or without the addition of a behavioural approach had superior outcome on general disability and most psychological factors compared to the mere prescription of physical activity.

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Section: Discussionmentioning

confidence: 99%

The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders

et al. 2016

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“…This contradicts the traditional view, considering neck and shoulder pain as more stress-related than extremity pain [ 3 , 4 , 13 , 17 ]. This assumption resulted in an increased focus on cognitive-behavioral treatments for the presumed stress-related musculoskeletal pain conditions, showing a lack of success [ 61 , 62 ]. The findings in this study underscores the importance of a comprehensive understanding of pain mechanisms in young people, as well as more appropriate and effective treatment and prevention approaches for this group.…”

Section: Discussionmentioning

confidence: 99%

Perceived stress and musculoskeletal pain are prevalent and significantly associated in adolescents: an epidemiological cross-sectional study

Østerås

Sigmundsson

Haga³

2015

BMC Public Health

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BackgroundLong-term musculoskeletal pain and negative stress are health risks with adverse long-term health effects, and these health risks seem to increase among young people. The mechanisms behind this are unclear. There is a need for a better understanding of perceived stress and musculoskeletal pain among adolescents, in order to improve health promotion and treatment approaches in this group.MethodsObjectives were to evaluate the current prevalence of perceived stress and musculoskeletal pain in 15 and 16 year olds, to explore stress-pain associations and the probability that perceived stress (PSQ) was related to the reporting of pain and variations in pain, and to investigate possible differences in stress between different types of musculoskeletal pain in the adolescents. A cross-sectional study was conducted. Elementary schools participated. The outcomes were stress (Perceived stress questionnaire; PSQ) and musculoskeletal pain (pain/no pain, pain sites, pain duration and pain intensity (Visual analogue scale; VAS).ResultsFifty-one point two percent (N = 422) reported pain, of which 70.8 % reported long-term pain. Some more girls (57.9 %) reported pain. 22.0 % of the study population reported moderate to severe stress (PSQ ≥ 0.45), of which 79.6 % were bothered by pain (Pearson Chi-square 38.47, p ≤ .001). All stress and pain variables were significantly associated (p < .01). The strongest association appeared between pain intensity (VAS) and stress (PSQ) (r = 0.40). Perceived stress (PSQ) was associated with the reporting of pain among the adolescents (Odds Ratio [OR] 1.68) and could explain some of the variation in pain intensity (VAS; β = 0.15, p < .001) and number of pain sites (β = 0.14, p < .01), according to the regression analyses. There were no mean differences in stress (PSQ) between different types of musculoskeletal pain.ConclusionsThere was high prevalence of musculoskeletal pain, long-term pain and moderate to severe stress (PSQ ≥ 0.45) in this study sample. Perceived stress (PSQ) was related to the reporting of musculoskeletal pain among the adolescents and could explain some of the variation in pain intensity (VAS) and number of pain sites. There were no differences in stress levels (PSQ) between different types of musculoskeletal pain in the adolescents.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2414-x) contains supplementary material, which is available to authorized users.

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“…Each physiotherapist received a half day practical training session with the project leader with written and oral communications on the rehabilitation programme. The structured physiotherapy programme was based on the management of other neck pain disorders, and included both a neuromuscular training component and a cognitive‐behavioural component (Gross et al, ; Monticone et al, ). The neuromuscular training component started with retraining the activation of the deep neck muscles, which progressed into isometric and dynamic exercises focused on improving the pattern and endurance of neck muscle activation.…”

Section: Methodsmentioning

confidence: 99%

Probing the mechanisms underpinning recovery in post‐surgical patients with cervical radiculopathy using Bayesian networks

Liew

Peolsson

Scutari

et al. 2020

European Journal of Pain

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Eur J Pain. 2020;24:909-920. wileyonlinelibrary.com/journal/ejp | 909 Abstract Background: Rehabilitation approaches should be based on an understanding of the mechanisms underpinning functional recovery. Yet, the mediators that drive an improvement in post-surgical pain-related disability in individuals with cervical radiculopathy (CR) are unknown. The aim of the present study is to use Bayesian networks (BN) to learn the probabilistic relationships between physical and psychological factors, and pain-related disability in CR. Methods: We analysed a prospective cohort dataset of 201 post-surgical individuals withCR. In all, 15 variables were used to build a BN model: age, sex, neck muscle endurance, neck range of motion, neck proprioception, hand grip strength, self-efficacy, catastrophizing, depression, somatic perception, arm pain intensity, neck pain intensity and disability. Results: A one point increase in a change of self-efficacy at 6 months was associated with a 0.09 point decrease in a change in disability at 12 months (t = −64.09, p < .001). Two pathways led to a change in disability: a direct path leading from a change in self-efficacy at 6 months to disability, and an indirect path which was mediated by neck and arm pain intensity changes at 6 and 12 months. Conclusions: This is the first study to apply BN modelling to understand the mechanisms of recovery in post-surgical individuals with CR. Improvements in painrelated disability was directly and indirectly driven by changes in self-efficacy levels. |

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Cognitive-behavioural treatment for subacute and chronic neck pain

Abstract: Analysis 3.9. Comparison 3 CBT versus other types of treatment (chronic NP), Outcome 9 Coping (intermediate-term follow-up

Cited by 67 publications

References 98 publications

The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders

The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders

Perceived stress and musculoskeletal pain are prevalent and significantly associated in adolescents: an epidemiological cross-sectional study

Probing the mechanisms underpinning recovery in post‐surgical patients with cervical radiculopathy using Bayesian networks

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