Cervical radiofrequency Neurotomy reduces psychological features in individuals with chronic whiplash symptoms

Smith, Ashley D., Jull, Gwendolen, Schneider, Geoff, Frizzell, Bevan, Hooper, Robert Allen, Dunne-Proctor, Rachel and Sterlin, Michele (2014) Cervical radiofrequency Neurotomy reduces psychological features in individuals with chronic whiplash symptoms. Pain Physician, 17 3: 265-274.

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Author Smith, Ashley D.
Jull, Gwendolen
Schneider, Geoff
Frizzell, Bevan
Hooper, Robert Allen
Dunne-Proctor, Rachel
Sterlin, Michele
Title Cervical radiofrequency Neurotomy reduces psychological features in individuals with chronic whiplash symptoms
Journal name Pain Physician   Check publisher's open access policy
ISSN 1533-3159
Publication date 2014
Year available 2014
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 17
Issue 3
Start page 265
End page 274
Total pages 10
Place of publication Paducah, KY United States
Publisher Association of Pain Management Anesthesiologists
Collection year 2015
Language eng
Formatted abstract
BACKGROUND: Individuals with chronic whiplash associated disorder (WAD) demonstrate various psychological features. It has previously been demonstrated that cervical radiofrequency neurotomy (cRFN) resolves psychological distress and anxiety. It is unknown if cRFN also improves or reduces a broader spectrum of psychological substrates now commonly identified in chronic whiplash, such as post-traumatic stress disorder (PTSD) and pain catastrophizing.

OBJECTIVES: To determine if reducing pain in the cervical spine (following cRFN) significantly reduces psychological features (distress, pain catastrophizing and post-traumatic stress symptoms) in individuals with chronic WAD.

SETTING: Tertiary spinal intervention centre in Calgary, Alberta, Canada.

STUDY DESIGN: Prospective observational study of consecutive patients.

METHODS: Patients: Fifty-three individuals with chronic whiplash associated disorder symptoms (Grade 2). Intervention: Cervical RFN following successful response to cervical facet joint blockade. Measures were made at 4 time points: 2 prior to RFN, and 1-month and 3-months post-RFN. Psychological measures included the General Health Questionnaire (GHQ-28); Pain Catastrophizing Scale (PCS) and the Post Traumatic Stress Diagnostic Scale (PDS). Self-reported pain (VAS) and disability (NDI) measures were also collected.

RESULTS: Pain, disability, psychological distress and pain catastrophization significantly decreased at both 1-month and 3 months following cervical RFN. There was no significant change in post-traumatic stress symptom severity (P = 0.39). Reducing pain via cRFN was associated with significant improvement in psychological distress and pain catastrophizing, but not posttraumatic stress symptoms.

LIMITATIONS: Individual administering questionnaires was not blinded to aim(s) of the study. Other psychological features possibly present in WAD were not measured.

CONCLUSION: Effective pain relief would seem a crucial element in the management of psychological features associated with chronic WAD.
Keyword Cervical facet joints
Pain catastrophizing
Post traumatic stress disorder
Psychological distress
Radiofrequency neurotomy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Health and Rehabilitation Sciences Publications
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