Psychological risk factors in back pain patients at an orthopaedic outpatient clinic

BACKGROUND: Psychological risk factors have shown to be important prognostic indicators of back surgery outcome. Prevalence of these risk factors has rarely been examined in an outpatient clinic population. Furthermore, it is unclear to which extent they play a role, in absence of routinely used psychological screening tools, in treatment assignment. OBJECTIVE: First aim of this study was to examine the prevalence of psychological risk factors in back pain patients at an orthopaedic outpatient clinic. Second aim was to investigate the prognostic value of these identified risk factors in treatment assignment by the orthopaedic surgeons (conservative vs. surgery). METHODS: Sixty-six adult back pain patients were included. Psychological risk factor prevalence was determined with the Hospital Anxiety and Depression Scale, Tampa Scale of Kinesiophobia and Pain Catastrophizing Scale. Prognostic value of these risk factors in treatment assignment was examined using statistics. RESULTS: Respectively, 30 (45% HADS Anxiety), 27 (41%, HADS Depression), 19 (29%, PCS) and 37 (56%, TSK) patients scored above cut-off. No prognostic value of risk factors in treatment assignment, was found. CONCLUSIONS: The majority of patients in our study is at risk of poor surgical outcome due to presence of psychological risk factors. Future studies should target the development of screening tools for an early identification of those at risk.