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

• Published in: Pain practice Vol. 16; no. 3; pp. 311 - 319
• Main Authors: Smith, Ashley D., Jull, Gwendolen A., Schneider, Geoffrey M., Frizzell, Bevan, Hooper, Robert A., Sterling, Michele M.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-03-2016
• Subjects: Adult; Catastrophization - psychology; catastrophizing; cervical medial branch rhizotomy; Chronic Disease; Cohort Studies; Denervation - instrumentation; Denervation - methods; disability; Disability Evaluation; Female; Humans; hyperalgesia; Male; Middle Aged; neck pain; Neck Pain - psychology; Neck Pain - surgery; Neurosurgical Procedures - methods; Pain Measurement; Pain Threshold; Predictive Value of Tests; Prospective Studies; psychology; Radio Waves; radiofrequency ablation; Self Report; Stress Disorders, Post-Traumatic - psychology; Treatment Outcome; Whiplash Injuries - psychology; Whiplash Injuries - surgery; whiplash-associated disorders; neck pain; catastrophizing; psychology; whiplash-associated disorders; disability; cervical medial branch rhizotomy; hyperalgesia; radiofrequency ablation; pain threshold
• ISSN: 1530-7085; 1533-2500
• DOI: 10.1111/papr.12282

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.