Pain-Related Fear, Lumbar Flexion, and Dynamic EMG Among Persons With Chronic Musculoskeletal Low Back Pain

Geisser, Michael E.; Haig, Andrew J.; Wallbom, Agnes; Wiggert, Elizabeth

doi:10.1097/00002508-200403000-00001

Cited by 195 publications

(117 citation statements)

References 43 publications

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“…It is possible that fear of pain might lead to muscle activation alterations that in turn lead to the spreading of pain 22, 42, 48 . Protective movement alterations potentiated by fear might cause sustained activations of muscles, producing intramuscular ischemic reactions that might directly or indirectly increase peripheral pain afferent activity 30 .…”

Section: Psychology Of Multisite Pain 16mentioning

confidence: 99%

An Experimental Approach to Examining Psychological Contributions to Multisite Musculoskeletal Pain

Niederstrasser

Slepian²,

Mankovsky-Arnold

et al. 2014

The Journal of Pain

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The present study examined the prospective value of pain catastrophizing, fear of pain, and depression in the prediction of multisite musculoskeletal pain following experimentally induced delayed onset muscle soreness (DOMS). The study sample consisted of 119 (63 females, 56 males) healthy university students. Measures of pain catastrophizing, fear of pain and depression were completed prior to the DOMS induction procedure. Analyses revealed that pain catastrophizing, and fear of pain prospectively predicted the experience of multisite pain following DOMSinduction. Analyses also revealed that women were more likely to experience multisite pain than men. There was no significant relation between depressive symptoms and the experience of multisite pain. The discussion addresses the mechanisms by which pain catastrophizing and fear of pain might contribute to the spreading of pain. Clinical implications of the findings are also addressed.Key words: multisite pain, fibromyalgia, catastrophizing, fear of pain, depression, sex differences.Highlight points: Pain catastrophizing, and fear of pain prospectively predict the experience of multisite pain following DOMS-induction.Women are more likely to experience multisite pain than men.Depressive symptoms have no influence on the experience of multisite pain.Fear of pain may underlie the experience of multisite pain through generalization. Psychology of multisite pain 3Recent research indicates that musculoskeletal pain frequently occurs at more than one anatomical site 6, 9, 47 . A survey of patients attending general practice clinics revealed that three quarters of chronic pain patients reported pain in more than one site 6 . Multisite pain has been associated with poorer prognosis as indicated by heightened susceptibility to chronicity, increased health and mental health problems and greater disability 11, 32, 33, 38 . In light of the high prevalence and increased costs associated with multisite pain, clinical researchers have called for more research on risk factors and determinants of multisite pain 33, 38 .Psychological factors such as pain catastrophizing, fear of pain and depression have been discussed as possible risk factors the development of multisite pain 4, 9 .Although it has been suggested that psychological variables might play a role in the onset or maintenance of multisite pain, the correlational nature of clinical studies precludes strong statements about causality. On the basis of research conducted to date, it cannot be ruled out that psychological variables such as pain catastrophizing, fear of pain and depression might be consequences rather than antecedents of multisite pain.The present study used an experimental approach to address the possible antecedent status of psychological variables in the experience of multisite pain. One advantage of using an experimental approach is that putative psychosocial risk factors can be assessed prior to pain induction, thereby permitting examination of the antecedent status of the variables. In addi...

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Section: Psychology Of Multisite Pain 16mentioning

confidence: 99%

An Experimental Approach to Examining Psychological Contributions to Multisite Musculoskeletal Pain

Niederstrasser

Slepian²,

Mankovsky-Arnold

et al. 2014

The Journal of Pain

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“…In many low back pain (LBP) studies there is strong evidence that those subjects with LBP exhibit an altered recruitment pattern of trunk muscles when compared with healthy subjects [15][16][17][18]. Some studies reported absence or delay of FRP during complete trunk flexion, which could be used to differentiate subjects with LBP from healthy or asymptomatic subjects [7,15,[17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies reported absence or delay of FRP during complete trunk flexion, which could be used to differentiate subjects with LBP from healthy or asymptomatic subjects [7,15,[17][18][19]. In contrast to LBP, there is still a lack of evidence about the changes that occur during FRP in chronic neck pain (CNP) patients.…”

Section: Introductionmentioning

confidence: 99%

A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects

2012

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Purpose The cervical flexion relaxation phenomenon (FRP) is a neck extensor myoelectric ''silence'' that occurs during complete cervical and lumbar flexion. In contrast to low back pain, the changes that occur during FRP in chronic neck pain (CNP) patients are still not clear. The aim of this study was to assess the characteristics of this phenomenon in the cervical region in CNP patients and controls. Methods Twenty-two women (23 ± 2.62 years) with chronic non-specific neck pain and 21 healthy women (23.4 ± 1.68 years) participated in this study. They accomplished a cervical flexion and extension from neutral position. Neck angle and surface electromyographic activity of cervical erector spinae (CES) and upper trapezius muscles were recorded. Appearance, onset and offset angle of the FRP were analysed and compared between the two groups. Results There were significant differences in the appearance of FRP between the two groups (P B 0.001). The FRP in the CES muscles was observed in 85.7 % of healthy subjects and in 36.3 % of CNP patients, and no FRP was observed in the upper trapezius. Results of this study show that the onset and offset of FRP parameters were significantly different between the two groups (P B 0.001).Conclusions The results of the present study indicate that FRP in CNP patients was seen less than the healthy subjects, and moreover the FRP period was reduced in CNP patients. Our results also suggest that the changes in FRP of CNP patients may be due to the increased CES activity in these patients.

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“…Although splinting of the affected area is initially protective, over time the response may become habitual, in relation to perceived pain preserved by fear of pain, rather than nociceptive signals (Neblett, 2007). Fear of pain and associated avoidance of movements considered pain provoking has been correlated with reduced spinal range of motion (Geisser, Haig, Wallbom, & Wiggert, 2004;Thomas & France, 2007;Trost et al, 2012), associated with prolonged disability (Linton et al, 2000), and has even been implicated in maladaptive patterns of motor control as back pain develops (Dankaerts & O"Sullivan, 2011;Trost et al, 2012).…”

Section: Biopsychosocial Modelmentioning

confidence: 99%

“…This ratio is significantly associated with disability, pain related fear and clinical status. It is also the only ratio sensitive to self-reported pain intensity, which has been poorly associated with FR changes in the past (Geisser et al, 2004;Neblett, Alschuler, et al, 2009). …”

Section: Quantifying Flexion Relaxationmentioning

confidence: 99%

The efficacy of surface electromyographic biofeedback assisted stretching for the treatment of chronic low back pain: A case-series

Moore

Mannion

Moran

2015

Journal of Bodywork and Movement Therapies

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Pain-Related Fear, Lumbar Flexion, and Dynamic EMG Among Persons With Chronic Musculoskeletal Low Back Pain

Cited by 195 publications

References 43 publications

An Experimental Approach to Examining Psychological Contributions to Multisite Musculoskeletal Pain

An Experimental Approach to Examining Psychological Contributions to Multisite Musculoskeletal Pain

A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects

The efficacy of surface electromyographic biofeedback assisted stretching for the treatment of chronic low back pain: A case-series

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