Psychological factors are associated with local and generalized pressure pain hypersensitivity, pain intensity, and function in people with chronic shoulder pain: A cross-sectional study

Musculoskelet Sci Pract. 2019 Dec:44:102064. doi: 10.1016/j.msksp.2019.102064. Epub 2019 Sep 21.

Abstract

Objectives: To explore the association between psychological factors and shoulder pain intensity, function, as well as local and generalized pressure pain hypersensitivity.

Design: a cross-sectional study.

Methods: 90 participants with chronic shoulder pain were included. Pressure pain thresholds determined the presence of pain hypersensitivity. Pain intensity, function, pain self-efficacy, emotional distress, and pain catastrophizing were also assessed. Analyses were adjusted for gender and age.

Results: The diagnosis of depression (yes/no answer) was associated with both greater local (standardized β = -0.19[95%CI -0.37 to -0.00]) and generalized (standardized β = -0.20[95%CI -0.39 to -0.01]) pressure pain hypersensitivity. Greater pain self-efficacy was associated with lower local pressure pain hypersensitivity (standardized β = 0.19[95%CI 0.04 to 0.38]). The standardized beta coefficient for the diagnosis of depression indicated that this variable showed the strongest association with pressure pain hypersensitivity. Additionally, greater pain self-efficacy was associated with lower pain intensity (standardized β = -0.34[95%CI -0.51 to -0.17]) and better function (standardized β = -0.47[95%CI -0.63 to -0.30]). Greater pain catastrophizing was associated with more pain intensity (standardized β = 0.35[95%CI 0.18 to 0.52]) and worse function (standardized β = 0.26[95%CI 0.10 to 0.43]). The standardized beta coefficients for pain catastrophizing and pain self-efficacy indicated that both variables showed the strongest association with shoulder pain intensity and function, respectively CONCLUSION: Psychological factors were associated with local and generalized pressure pain hypersensitivity, pain intensity, and function in people with chronic shoulder pain.

Keywords: Chronic pain; Pain threshold; Psychological factors; Shoulder pain.

MeSH terms

  • Anxiety / psychology
  • Catastrophization / psychology*
  • Chronic Pain / psychology*
  • Cross-Sectional Studies
  • Depression / psychology
  • Fear / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain Threshold / psychology*
  • Pressure
  • Self Efficacy
  • Shoulder Pain / physiopathology*
  • Shoulder Pain / psychology*