The relationship between activity and pain in patients 6 months after lumbar disc surgery: Do pain‐related coping modes act as moderator variables?

Abstract

The assessment of pain-related coping modes yielded an important differentiation between subgroups of LBP patients 6 months after surgery. Endurance copers displayed signs of overuse in their daily behavior in spite of pain than adaptive copers. The one fear avoidance coper tends to do less physical activity in the sense of underuse.

Avoidance or Incapacitation

“…17,18 This is not surprising as everyone has a different physical capacity and in a chronic pain population this would not be exclusively determined by avoiding or persisting with activity. While low…”

Fear-Avoidance Model of Chronic Pain

“…Undue suppression of normal, pain-related interruption of daily activities may lead to an overuse or overload of musculoskeletal structures, thereby attenuating physical recovery. Preliminary evidence suggests that excessive task persistence might predict less successful rehabilitation (see 89,90 ), and may eventually increase vulnerability for inflammatory diseases 91 . However, more systematic research on the potential effects of long term persistence is needed.…”

The relationship between perceived promotion of autonomy/dependence and pain-related disability in older adults with chronic pain: the mediating role of self-reported physical functioning

“…For example, one potential mediator could be fear of movement/(re)injury, which has been shown to be a strong predictor of pain-related disability in chronic pain patients (e.g., Vlaeyen et al, 1995); another potential mediator could be an individual's activity patterns (e.g., avoidance, overdoing and pacing), which also play an important role in the development and maintenance of chronic pain (Hasenbring et al, 2006;Nielson, et al, 2001;Philips & Rachman, 1996); a final potential mediator could be pain-related self-efficacy, which has been associated with lower levels of pain intensity, disability, depression and anxiety (e.g., Arnstein, 2000;Costa et al, 20 2011; Nicholas, 2007). Indeed, from a biopsychosocial perspective on chronic pain (e.g., Turk & Gatchel, 2013) the present study only addresses how social and physical variables influence pain disability/severity.…”

“…To date, a large body of research has identified cognitive (e.g., catastrophizing, pain-related self-efficacy), affective (e.g. pain-related fear) and behavioral (e.g., activity dis/engagement) determinants of painrelated disability (e.g., Arnstein, 2000;Costa et al, 2011;Hasenbring et al, 2006;Nicholas, 2007;Nielson, et al, 2001;Philips & Rachman, 1996;Vlaeyen et al, 1995). The extent to which these determinants may act as mediators of the influence of perceived promotion of autonomy and dependence on pain-related disability is yet to be explored.…”