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Barreto R.P.G.1, Ribeiro L.P.1, Lucera G.M.1, Arrais-Lima C.1, Camargo P.R.1
1Universidade Federal de São Carlos, Laboratory of Analysis and Intervention of the Shoulder Complex, São Carlos, Brazil
Background: Pain catastrophizing (PC) is an important cognitive pattern, and seems to be related to greater intensity of pain, dysfunction, and symptoms persistence. Studies have shown that PC may play a role in the development of chronic pain, especially in patients with low back pain. However, data about PC related to shoulder pain is still scarce in literature.
Purpose: The primary purpose of this study was to verify the association between PC and duration of pain in patients with unilateral shoulder pain, and between PC and function of the upper limbs. As secondary objectives, the level of PC between men and women was compared, as well as between patients with pain in the dominant and nondominant side.
Methods: One-hundred and four patients with unilateral shoulder pain (57 men and 47 women; 40 ± 16 years; 1.69 ± 0.09 m; 73.56 ± 13.05 kg; 38.4 ± 62 months of pain duration) for at least 4 weeks participated in this study. Individuals were excluded if they had involvement of cervical spine, history of shoulder surgery, recurrent glenohumeral dislocation and symptoms of adhesive capsulitis. All patients completed the Brazilian version of the Pain Catastrophizing Scale (PCS) to measure PC and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) to measure upper limb function. Pearson correlation was used to measure the association between variables. The difference between genders and sides was verified by independent T-test. A p value of less than 0.05 was considered significant.
Results: The average score of the PCS and DASH was 19.5 ± 12.13 and 23 ± 15.92, respectively. PCS was not correlated to duration of pain (p=0.16, r=-0.13). However, PCS and DASH exhibited a positive and moderate correlation (p 0.05, r=0.45). All subscales of PCS were positively correlated to DASH, magnification (p 0.05, r=0.38), rumination (p 0.05, r=0.35), and helplessness (p 0.05, r=0.49). There was no difference in the level of PC between men and women (p=0.42) and between patients with dominant and nondominant side involvement (p=0.10).
Conclusion(s): The level of PC is not related to the duration of pain. Higher level of PC seems to jeopardize the functional status of the upper limbs. PC is not influenced by gender and dominance. Further studies comparing clinical relevant changes controlled by the level of PC to estimate the responsiveness of this measurement in patients with shoulder pain are still necessary.
Implications: The findings suggest that PCS should be used to evaluate individuals with shoulder pain as upper limb function appears to be related to PC. The level of PC could potentially indicate if additional therapies should be addressed to treat patients with shoulder pain such as pain education or cognitive-behavior therapy. However, more studies assessing this construct in patients with shoulder pain are needed.
Funding acknowledgements: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes)
Topic: Musculoskeletal: upper limb
Ethics approval: Study approved by the Ethics Committee of Universidade Federal de São Carlos (report number 1.394.925), BR
All authors, affiliations and abstracts have been published as submitted.
