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.

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