Felipe Reis1,2, Fernanda Guimarães1, Leandro Calazans Nogueira1,3, Ney Meziat-Filho3, Tiago A Sanchez4, Timothy Wideman5. 1. a Department of Physiotherapy , Instituto Federal do Rio de Janeiro (IFRJ) , Rio de Janeiro , Brazil. 2. b Postgraduation Progam, Clinical Medicine Department , Universidade Federal do Rio de Janeiro (UFRJ) , Rio de Janeiro , Brazil. 3. c Postgraduation Progam in Rehabilitation Sciences , Centro Universitário Augusto Motta (UNISUAM) , Rio de Janeiro , Brazil. 4. d Department of Radiology , Universidade Federal do Rio de Janeiro (UFRJ) , Rio de Janeiro , Brazil. 5. e Physical Therapy Department , McGill University , Montreal , Canada.
Abstract
BACKGROUND: It has been speculated that there is an association between pain area and psychological factors in chronic musculoskeletal pain conditions; however, this relation is not well established. PURPOSE: To investigate the association between pain distribution and psychological factors in chronic musculoskeletal pain conditions. STUDY DESIGN: Systematic review. METHODS: We searched the following databases using optimized search strategies: MEDLINE, PsycINFO, Scopus, Web of Science and Cochrane. Studies were included if they investigated the relation between pain area using a pain drawing (PD) and psychological factors measured by any consistent available method. RESULTS: Eleven articles were included. A total of 1301 participants with different musculoskeletal pain conditions, including low back pain, whiplash-associated disorders and fibromyalgia took part in the studies. In three studies, the correlation between pain area and depression was weak (r = 0.15, p = N/A; r = 0.26, p < 0.05; r = 0.25, p = 0.01). Depression seemed to be a risk factor for pain in more body areas in one study (relative risk = 6.09, 95% CI = 1.1-33.5; p < 0.05). The relation between pain area and other psychological factors such as anxiety, kinesiophobia, catastrophizing, memory disturbances and concentration difficulties was also reported. CONCLUSIONS: A definitive answer on the relation of psychological factors and pain area is not available; the findings suggest that only depression might have a weak relation with pain area. Future studies that investigate sensory, psychological, emotional, cognitive and behavioral aspects, and also more accurate methods of PD assessment, are needed.
BACKGROUND: It has been speculated that there is an association between pain area and psychological factors in chronic musculoskeletal pain conditions; however, this relation is not well established. PURPOSE: To investigate the association between pain distribution and psychological factors in chronic musculoskeletal pain conditions. STUDY DESIGN: Systematic review. METHODS: We searched the following databases using optimized search strategies: MEDLINE, PsycINFO, Scopus, Web of Science and Cochrane. Studies were included if they investigated the relation between pain area using a pain drawing (PD) and psychological factors measured by any consistent available method. RESULTS: Eleven articles were included. A total of 1301 participants with different musculoskeletal pain conditions, including low back pain, whiplash-associated disorders and fibromyalgia took part in the studies. In three studies, the correlation between pain area and depression was weak (r = 0.15, p = N/A; r = 0.26, p < 0.05; r = 0.25, p = 0.01). Depression seemed to be a risk factor for pain in more body areas in one study (relative risk = 6.09, 95% CI = 1.1-33.5; p < 0.05). The relation between pain area and other psychological factors such as anxiety, kinesiophobia, catastrophizing, memory disturbances and concentration difficulties was also reported. CONCLUSIONS: A definitive answer on the relation of psychological factors and pain area is not available; the findings suggest that only depression might have a weak relation with pain area. Future studies that investigate sensory, psychological, emotional, cognitive and behavioral aspects, and also more accurate methods of PD assessment, are needed.
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