Pretreatment anxiety and pain acceptance are associated with response to trigger point injection therapy for chronic myofascial pain

• Published in: Pain medicine (Malden, Mass.) Vol. 16; no. 10; pp. 1955 - 1966
• Main Authors: Healy, Gerard M., Finn, David P., O'Gorman, David A., Maharaj, Chris, Raftery, Miriam, Ruane, Nancy, Mitchell, Caroline, Sarma, Kiran, Bohacek, Marek, McGuire, Brian E.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.10.2015
• Subjects: Adaptation, Psychological; Adult; Aged; Analgesics - administration & dosage; Anxiety; Anxiety - complications; Anxiety - psychology; Catastrophization - complications; Catastrophization - psychology; Chronic Disease; Chronic Pain; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Myofascial; Myofascial Pain Syndromes - complications; Myofascial Pain Syndromes - drug therapy; Myofascial Pain Syndromes - psychology; Pain Acceptance; Pain management; Treatment Outcome; Trigger Point; Trigger Points; Myofascial; Pain Acceptance; Anxiety; Trigger Point; Chronic Pain
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1111/pme.12781

Background and Aim This study examined the psychosocial profile of patients who responded or did not respond to trigger point injection therapy for chronic myofascial pain. Methods Seventy one patients with a diagnosis of chronic myofascial pain of the paraspinous muscles completed a pretreatment questionnaire measuring demographic and social factors, and validated scales to assess pain intensity, pain interference (physical and emotional), and defined psychological characteristics (pain catastrophizing, pain acceptance, pain self‐efficacy, mood and anxiety). Trigger point injection therapy of the affected areas of myofascial pain was performed and follow‐up was conducted by telephone at one week (n = 65) and one month (n = 63) post intervention to assess treatment outcome (pain intensity and pain‐related physical interference). Results At one week follow‐up and one‐month follow‐up, using pain‐related physical interference as the outcome measure, we found that those who responded well to treatment were characterized by a lower level of pretreatment anxiety and a higher level of pain acceptance, with anxiety being the strongest predictor. Conclusion These results suggest that responses to interventional pain management in chronic myofascial paraspinous pain may be influenced by psychological characteristics, especially pretreatment anxiety.