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Pain Catastrophizing in Orthopedic Surgery: A Bibliometric Analysis of Global Research Trends, Collaborative
Hugo Placer-Sanchez1, Latha Ganti2, Omar Viswanath3
1Washington University in St. Louis.
Importance:
Pain catastrophizing is a pain-related cognitive construct involving persistent rumination about pain, magnification of pain threat, and feelings of helplessness. In musculoskeletal and perioperative contexts, higher catastrophizing is associated with greater pain intensity, disability, distress, delayed recovery, opioid use, and healthcare utilization. Within orthopedic populations, preoperative psychological status is increasingly recognized as relevant to postoperative pain and patient-reported outcomes.
Objective:
To analyze worldwide research patterns on pain catastrophizing from 2001 to 2026 in orthopedic surgery, including publication growth, document types, subject categories, journals, institutions, funding bodies, and co-authorship networks.
Methods:
A bibliometric analysis was performed using Web of Science Core Collection records related to pain catastrophizing and orthopedic or musculoskeletal surgery. Records were exported and analyzed through VOSviewer network mapping.
Results:
The dataset was dominated by original articles (1,173 visible records), followed by review articles (95). Annual output was modest in the early 2000s, increased after 2008, and showed sustained growth through the early and mid-2020s, with lower 2026 counts reflecting incomplete indexing. The most visible subject categories were Neurosciences/Neurology, Orthopedics, Anesthesiology, Rehabilitation, and General/Internal Medicine. The leading journals included Pain, Journal of Pain, Clinical Journal of Pain, European Journal of Pain, and Pain Medicine. Institution and author maps showed visible collaboration hubs, including major contributions from Harvard-affiliated institutions and investigators such as David Ring, Steven Z. George, Mira Meeus, Mark P. Jensen, Michael J. Sullivan, Jo Nijs, Robert R. Edwards, and Lars Arendt-Nielsen.
Conclusions:
Pain catastrophizing research in orthopedic surgery has become a sustained, interdisciplinary literature. The field is strongly rooted in pain science, but its clinical meaning is closely tied to psychiatry and behavioral health because catastrophizing connects fear, mood, coping, opioid use, rehabilitation behavior, and surgical recovery.