Are pain-related fears mediators for reducing disability and pain in patients with complex regional pain syndrome type 1?

The objective of this study was to investigate whether pain-related fears are mediators for decreasing disability and pain in patients with Complex Regional Pain Syndrome type 1 when treating with Pain Exposure Physical Therapy. The experimental group were given Pain Exposure Physical Therapy in a maximum of five treatment sessions; conventional treatment following the Dutch multidisciplinary guideline was administered to the control group. 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 reduction 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 were significantly reduced 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. The study did not find anything to suggest 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.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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