Low Pain Catastrophization and Disability Predict Successful Outcome to Radiofrequency Neurotomy in Individuals with Chronic Whiplash

Pain Pract. 2016 Mar;16(3):311-9. doi: 10.1111/papr.12282. Epub 2015 Jan 9.

Abstract

Objectives: Physical and psychological symptoms of individuals with chronic whiplash-associated disorders (WAD) are modulated by successful treatment with cervical radiofrequency neurotomy (cRFN). However, not all individuals respond to cRFN, and it is unknown which clinical features predict successful response to cRFN.

Methods: This prospective cohort study investigated 53 individuals with chronic WAD (36 female, 17 male; mean age = 44.7 ± 10.9 (SD) years) who underwent cRFN. Predictor variables measured at baseline (prior to RFN) included self-reported pain (VAS), disability (NDI), post-traumatic stress symptoms (PDS), pain catastrophizing (PCS), and measures of sensory hypersensitivity (pressure and cold pain thresholds). The outcome measure was perceived Global Rating of Change (where scores ≥ 4 were classified as a successful response) 3 months post-cRFN.

Results: Univariate logistic regression demonstrated that lower levels of disability and pain catastrophizing were associated with successful response of cRFN (both P < 0.05). Multivariable logistic regression demonstrated that low levels of pain catastrophizing and disability remained significant predictors of a successful response to cRFN (both P < 0.05).

Conclusions: Low levels of pain catastrophizing and disability independently predicted a successful response to cRFN in patients with chronic WAD.

Keywords: catastrophizing; cervical medial branch rhizotomy; disability; hyperalgesia; neck pain; pain threshold; psychology; radiofrequency ablation; whiplash-associated disorders.

MeSH terms

  • Adult
  • Catastrophization / psychology*
  • Chronic Disease
  • Cohort Studies
  • Denervation / instrumentation
  • Denervation / methods*
  • Disability Evaluation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Pain / psychology
  • Neck Pain / surgery
  • Neurosurgical Procedures / methods*
  • Pain Measurement
  • Pain Threshold
  • Predictive Value of Tests
  • Prospective Studies
  • Radio Waves
  • Self Report
  • Stress Disorders, Post-Traumatic / psychology
  • Treatment Outcome
  • Whiplash Injuries / psychology
  • Whiplash Injuries / surgery*