Are pain coping strategies and neuropathic pain associated with a worse outcome after conservative treatment for Achilles tendinopathy? A prospective cohort study

Iris F. Lagas*, Arco C. van der Vlist, Robert F. van Oosterom, Peter L. J. van Veldhoven, Jan H. Waarsing, Sita M. A. Bierma-Zeinstra, Jan A. N. Verhaar, Robert-Jan de Vos

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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To analyse whether (1) passive or active pain coping strategies and (2) presence of neuropathic pain component influences the change of Achilles tendinopathy (AT) symptoms over a course of 24 weeks in conservatively-treated patients.
Prospective cohort study.
Patients with clinically-diagnosed chronic midportion AT were conservatively treated. At baseline, the Pain Coping Inventory (PCI) was used to determine scores of coping, which consisted of two domains, active and passive (score ranging from 0 to 1; the higher, the more active or passive). Presence of neuropathic pain (PainDETECT questionnaire, −1 to 38 points) was categorized as (a) unlikely (≤12 points), (b) unclear (13–18 points) and (c) likely (≥19 points). The symptom severity was determined with the validated Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire (0–100) at baseline, 6, 12 and 24 weeks. We analysed the correlation between (1) PCI and (2) PainDETECT baseline scores with change in VISA-A score using an adjusted Generalized Estimating Equations model.
Of 80 included patients, 76 (95%) completed the 24-weeks follow-up. The mean VISA-A score (standard deviation) increased from 43 (16) points at baseline to 63 (23) points at 24 weeks. Patients had a mean (standard deviation) active coping score of 0.53 (0.13) and a passive score of 0.43 (0.10). Twelve patients (15%) had a likely neuropathic pain component. Active and passive coping mechanisms and presence of neuropathic pain did not influence the change in AT symptoms (p = 0.459, p = 0.478 and p = 0.420, respectively).
Contrary to widespread belief, coping strategy and presence of neuropathic pain are not associated with a worse clinical outcome in this homogeneous group of patients with clinically diagnosed AT.
Original languageEnglish
Pages (from-to)871-875
Number of pages5
JournalJournal of Science and Medicine in Sport
Issue number9
Publication statusPublished - 1 Sept 2021

Bibliographical note

Funding Information:
This research is funded by the Dutch Arthritis Association and the Anna Foundation. Both are non-commercial organizations and were not involved in the content of this publication. The views expressed in the submitted article are our own and not an official position of the institution or funder. The HAT study was approved by the Medical Research Ethics Committee of Southwest Holland, the Netherlands (MEC-14-100). Trial registration number (The Netherlands Trial Register): ID number: NL4686, (identifier: NCT02996409)

Publisher Copyright:
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