The association between cognitive factors, pain and disability in patients with idiopathic chronic neck pain

Purpose. The aim of this study was to establish the relationship between known cognitive factors and levels of pain and disability in patients with idiopathic chronic neck pain. Method. Ninety-four patients referred for physiotherapy because of chronic neck pain completed measures of pain, disability, catastrophising, pain-related fear, pain vigilance and awareness and self-efficacy beliefs. Hierarchical multiple regression analyses were then performed to establish whether the cognitive factors were significant determinants of levels of pain and disability. Results. The cognitive measures were significantly related to levels of pain and disability, explaining 23% of the variance in pain intensity and 30% of the variance in disability. Specifically, greater catastrophising (beta = 0.37, p < 0.05) and lower pain vigilance and awareness (beta = -0.32, p < 0.05) were associated with greater pain intensity. Moreover, greater catastrophising (beta = 0.26, p < 0.05) and lower functional self-efficacy beliefs (beta = -0.34, p < 0.001) were significantly associated with greater levels of disability. Conclusions. Cognitive factors were strongly related to levels of pain and disability in patients with chronic neck pain. In view of this, targeting the modification of these cognitive factors should be an integral part of therapy when treating patients with idiopathic chronic neck pain.