Chronic Back Injury ResearchMeasuring fear of movement/(re)injury in chronic low back pain using implicit measures.Primary Author: Maaike LeeuwPrimary Author: Department of Medical, Clinical and Experimental Psychology, Maastricht University, Maastricht, The Netherlands. M.Leeuw@DMKEP.Unimaas.nlDate Published: 2007 03 16Abstract: Fear of movement/(re)injury is assumed to contribute to the development and maintenance of chronic low back pain (CLBP) in a subgroup of patients. Studying fear of movement/(re)injury with implicit attitude measures, without the awareness of the patient, might be a valuable addition to self-report questionnaires. The aims of the current study were to investigate whether CLBP patients demonstrate more implicit fear of movement/(re)injury than healthy controls, and whether 2 implicit measures are related to each other, and to an explicit self-report measure of fear of movement/(re)injury. A group of 66 CLBP patients and 30 healthy controls took part in this study. In addition to self-report questionnaires, fear of movement/(re)injury was implicitly assessed by the Extrinsic Affective Simon Task (EAST) and the Go-No-Go-Association Task (GNAT) that aimed to determine the association between back-stressing movements and the evaluation "threatening". On both implicit tasks it was found that neither CLBP patients nor healthy controls demonstrated implicit fear of movement/(re)injury, and that CLBP patients did not differ from healthy controls in their level of implicit fear of movement/(re)injury. In general, no associations were found between the EAST and the GNAT, or between implicitly measured and self-reported fear of movement/(re)injury. One major caveat in drawing inferences from these findings is the poor reliability of these implicit measures. Research towards the psychometric properties of these measures should first be expanded before modifying, and applying, them to more complex domains such as fear of movement/(re)injury.
Evaluation of influence of gender, occupational injury, and smoking on chronic low back pain of facet joint origin: a subgroup analysis.Primary Author: Laxmaiah ManchikantiPrimary Author: Pain Management Center of Paducah, 2831 Lone Oak Road, Paducah, KY 42003, USA. drm@asipp.orgDate Published: 2006 08 09Abstract: The prevalence of persistent low back pain secondary to involvement of lumbosacral facet joints has been described in controlled studies as varying from 15% to 52% based on types of population and settings studied. Previous studies have shown variances in elderly populations, and postlumbar laminectomy patients. But no variations were observed in obese patients or patients with somatization disorder. Based on the individual results, it appears that facet joint pain may be less prevalent in patients with occupational injury and more prevalent in women and smokers. This analysis was based on a combination of the results of two previous studies with a total number of 320 patients to evaluate the influence of gender, occupational injury and smoking on prevalence of facet joint pain. Facet joints were investigated with diagnostic blocks initially using lidocaine 1%, followed by bupivacaine 0.25%, usually 2 to 4 weeks apart in these studies. The prevalence of facet joint pain in men was 38% (95% CI, 29% to 47%) compared to 43% (95% CI, 36% to 50%) in women; 43% (95% CI, 33% to 53%) in non-smokers, compared to 41% (95% CI, 30% to 52%) in heavy smokers; and 28% (95% CI, 18% to 38%) in occupational injury patients compared to 44% (95% CI, 36% to 52%) with a history of gradual onset. False-positive rates varied from 28% to 46%. In conclusion, based on the results of this evaluation, women and men, smokers and nonsmokers suffer with similar prevalence rates of facet joint pain in chronic low back pain; whereas occupational injury patients suffer with lesser prevalence (28%) compared to patients with gradual onset (44%) of low back pain.
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