Research Paper Title

Unique Contributions of Body Diagram Scores and Psychosocial Factors to Pain Intensity and Disability in Patients With Musculoskeletal Pain in a Military Primary Care Clinic.

Background

Body diagrams are often use to document symptom and have also been used as a proxy to assess psychological influence. However, literature on their value for this purpose is conflicting.

The purpose of this research was to examine the moderating influence of psychological factors on the relationship between body diagram score and both pain and disability.

Methods

Retrospective cross-sectional cohort of patients reporting to a primary care clinic for a musculoskeletal pain.

Pain, numbness, and/or tingling was denoted on a body diagram. Fear avoidance beliefs (FABQ) ,pain catastrophizing (PCS), and region-specific self-report disability measures were collected. Single- and composite-symptom scoring methods were examined.

The scoring method exhibiting the highest correlation with pain intensity and disability was used for subsequent analyses. Hierarchical linear regression analyses were used to determine the moderating effects of PCS and FABQ on the relationship between body diagram score and both pain and disability.

Results

Compared to pain distribution alone, overall symptom distribution scores had higher correlations with both pain intensity (r=.318, p<.001 vs. r=.252, p<.001) and disability (r=.259, p<.001 vs. r=.207, p<.001). PCS and FABQ explained between 16-17% of the variance in pain intensity, and 8% of variance in disability (all p<.001). PCS moderated the relationship between diagram score and pain intensity.

Conclusions

Composite symptom distribution may be more informative than pain distribution alone in clinical settings. High levels of pain catastrophizing strongly influence pain intensity regardless of symptom distribution, whereas at lower levels of pain catastrophizing, symptom distribution and pain intensity are more closely related.

Reference

Rhon, D.I., Lentz, T.A. & George, S.Z. (2016) Unique Contributions of Body Diagram Scores and Psychosocial Factors to Pain Intensity and Disability in Patients With Musculoskeletal Pain in a Military Primary Care Clinic. The Journal of Orthopaedic and Sports Physical Therapy. 5, pp.1-24. DOI: 10.2519/jospt.2017.6778. [Epub ahead of print].