The perception of pain and pain-related cognitions in subacute whiplash-associated disorders: its influence on prolonged disability

Disabil Rehabil. 2006 Mar 15;28(5):271-9. doi: 10.1080/09638280500158323.


Purpose: To clarify the relations between the sensory, affective and cognitive dimensions of pain and to analyse what influence these components have on persistent disability in patients with subacute whiplash-associated disorders (WAD).

Method: The data was obtained from an on-going randomised controlled trial (RCT) on 47 patients. The sensory dimension of pain was evaluated with a visual analogue scale (VAS) diary and a Painometer. The affective dimension was assessed using the Painometer. The Tampa Scale for Kinesiophobia (TSK) and the Self-Efficacy Scale (SES) were used as measures of pain-related cognitions. The Pain Disability Index (PDI) was used as the outcome measure.

Results: Forty patients (85%) completed the trial. The correlations between the sensory and affective dimensions of pain were non-significant, which indicates that they are two independent constructs that describe various dimensions of whiplash-related pain. High pain intensity and pain affect, more widespread pain, and high fear of movement/(re)injury corresponded to low self-efficacy. Multiple regression analyses showed that self-efficacy was the most important predictor of persistent disability contributing to 42% of the variation in the PDI score.

Conclusion: The treatment approach for patients with subacute WAD should incorporate the multidimensional nature of pain and to prevent disability special effort should be made to enhance the patient's self-efficacy beliefs.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cognition*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / classification
  • Pain / etiology
  • Pain / psychology*
  • Pain Measurement / methods*
  • Pain Threshold
  • Regression Analysis
  • Self Efficacy
  • Severity of Illness Index
  • Whiplash Injuries / complications
  • Whiplash Injuries / rehabilitation*