Psychosocial Aspects of Disabling Musculoskeletal Pain

Vranceanu, Ana‐Maria; Barsky, Arthur J.; Ring, David

doi:10.2106/jbjs.h.01512

Cited by 244 publications

(160 citation statements)

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“…Psychosocial factors have been shown to influence baseline scores on many commonly used upper extremity orthopaedic outcome scales [6,17,23,25,26,28,33]. Higher levels of psychological distress also correlate with inferior patient-reported outcomes after surgical intervention in other areas of orthopaedics [4,16,22,31,32,34].…”

Section: Discussionmentioning

confidence: 99%

“…We [23] and others [6,28] have reported that greater distress is associated with lower preoperative self-assessment scores in patients with shoulder pathology, but to our knowledge, this is the first investigation to consider the relationship of distress and outcome scores after arthroscopic rotator cuff repair. Results from populations undergoing total joint arthroplasty [16], surgery for degenerative spine conditions [19,31,32], hip arthroscopy [22], or upper extremity surgery [33] have suggested that for distressed patients, higher levels of pain and lower levels of function often persist after surgical intervention. It is possible that our results here differ from most prior studies because of an underlying difference in the nature of rotator cuff disease.…”

Section: Discussionmentioning

confidence: 99%

“…Higher levels of psychological distress correlate with greater pain and decreased function in patients with low back pain [3,10], surgical spine conditions [1,4,31,32], hip and knee arthritis [11,14,16], femoroacetabular impingement [22,24], shoulder and rotator cuff pathology [6,23,27,28], and orthopaedic hand and elbow conditions [17,25,33,34].…”

Section: Introductionmentioning

confidence: 99%

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One-year Patient-reported Outcomes After Arthroscopic Rotator Cuff Repair Do Not Correlate With Mild to Moderate Psychological Distress

Potter

Wylie

Greis

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Patients with shoulder and rotator cuff pathology who exhibit greater levels of psychological distress report inferior preoperative self-assessments of pain and function. In several other areas of orthopaedics, higher levels of distress correlate with a higher likelihood of persistent pain and disability after recovery from surgery. To our knowledge, the relationship between psychological distress and outcomes after arthroscopic rotator cuff repair has not been similarly investigated. Questions/purposes (1) Are higher levels of preoperative psychological distress associated with differences in outcome scores (visual analog scale [VAS] for pain, Simple Shoulder Test, and American Shoulder and Elbow Surgeons score) 1 year after arthroscopic rotator cuff repair? (2) Are higher levels of preoperative psychological distress associated with less improvement in outcome scores (VAS for pain, Simple Shoulder Test, and American Shoulder and Elbow Surgeons score) 1 year after arthroscopic rotator cuff repair? (3) Does the prevalence of psychological distress in a population with full-thickness rotator cuff tears change when assessed preoperatively and 1 year after arthroscopic rotator cuff repair? Methods Eighty-five patients with full-thickness rotator cuff tears were prospectively enrolled; 70 patients (82%) were assessed at 1-year followup. During the study period, the three participating surgeons performed 269 rotator cuff repairs; in large part, the low overall rate of enrollment was related to two surgeons enrolling only two patients total in the initial 14 months of the study. Psychological distress was quantified using the Distress Risk Assessment Method questionnaire, and patients completed self-assessments including the VAS for pain, the Simple Shoulder Test, and the American Shoulder and Elbow Surgeons score preoperatively and 1 year after arthroscopic rotator cuff repair. Fifty of 85 patients (59%) had normal levels of distress, 26 of 85 (31%) had moderate levels of distress, and nine of 85 (11%) had severe levels of distress. Statistical models were used to assess the effect of psychological distress on patient self-assessment of shoulder pain and function at 1 year after surgery. Results With the numbers available, distressed patients were not different from nondistressed patients in terms of One of the authors certifies that he (PEG), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of less than USD 10,000 of research support funding from DePuy Mitek (Raynham, MA, USA). One of the authors certifies that he (RTB), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of USD 10,000 to USD 100,000 of research support funding from DePuy Mitek. One of the authors certifies that he (RZT), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of USD 100,000 to USD 1,000,000 of research support funding from the Depart...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

One-year Patient-reported Outcomes After Arthroscopic Rotator Cuff Repair Do Not Correlate With Mild to Moderate Psychological Distress

Potter

Wylie

Greis

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Orthopaedic surgeons expect fewer symptoms and limitations when surgery improves motion, when radiographic arthritis is less severe, and when a sutured rotator cuff defect heals. We are surprised to find that greater motion, more severe radiographic arthritis, and persistent defects after surgery are not always associated with reductions in symptoms and functional limitations [4]. We are puzzled by the ability of sham surgery and injection to relieve symptoms [5].…”

mentioning

confidence: 99%

“…With more routine use of PROMs, surgeons will want to pay more attention to the factors that have the strongest influence on these scores: Stress, distress, and ineffective coping strategies [4]. The influence of mindset and circumstances on musculoskeletal illness is evident to orthopedic surgeons of all subspecialties.…”

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confidence: 99%