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Pain catastrophizing is associated with higher pain intensity following carpal tunnel release: a prospective
Rebecca Helene Sletten1, Unni Olsen2, Arild Aamodt1
1Department of Orthopaedic Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway.
Objectives:
This study aims to examine preoperative sociodemographic, clinical, and psychological factors associated with acute worst pain intensity following open carpal tunnel release (CTR).
Methods:
This prospective observational study included 83 patients between 18 and 79 years undergoing primary outpatient CTR. All patients filled in consent forms and a questionnaire that assessed demographics, comorbidities, pain and function, sleep quality and pain catastrophizing. The primary outcome was worst pain intensity during the first three postoperative days. Linear regression analyses were done to estimate associations between age, sex, education, comorbidity, pain catastrophizing and sleep quality, and worst postoperative pain intensity.
Results:
The patients mean age was 60 years and most were women (64 %). Patients rated their worst preoperative pain to 4.5 on a scale from 0 to 10, and worst pain intensity of 5.3 during the first three postoperative days. Postoperatively, 47 % of the patients experienced moderate pain and 32, 5 % reported severe pain in the three first days. In the univariable analyses, poorer sleep quality, more pain catastrophizing, more PRWHE hand pain and disability, and higher preoperative pain were associated with more severe postoperative pain. In the multivariable analysis, only higher level of pain catastrophizing remained associated with more severe postoperative pain.
Conclusion:
Higher preoperative pain catastrophizing was independently associated with higher postoperative pain intensity after CTR. This factor may be useful as part of preoperative screening to identify patients at higher risk for more severe postoperative pain. REC approval # 2018/1562.
