Department of Orthopaedics & Physical Medicine, Medical University of South Carolina, Charleston, SC, USA.
Foot Ankle Int. 2022 Oct;43(10):1340-1345. doi: 10.1177/10711007221106472. Epub 2022 Jul 6.
The Pain Catastrophizing Scale (PCS) is a measure of how patients emotionally respond to pain. It is composed of 3 subscales-rumination, magnification, and helplessness-which address intrusive thoughts of pain, expectations of negative outcomes, and inability to cope with pain. Our purpose is to compare baseline PCS scores with other baseline patient-reported outcome measures (PROMs) in patients with plantar fasciitis (PF) or chronic ankle instability (CAI).
We retrospectively reviewed 201 patients who reported at least 1 pretreatment PCS subscore and were diagnosed with PF or CAI between 2015 and 2020 in a single fellowship-trained foot and ankle surgeon's clinic. Demographics, comorbidities, treatments, other baseline PROMs (i.e., visual analog scale [VAS], Pain Disability Index [PDI], 12-Item Short Form Survey [SF-12], 8-Item Somatic Symptom Scale [SSS-8]), and postoperative outcomes were recorded.
The PCS total score and its subscores significantly correlated with the total score and/or subscores of each PROM. Higher PCS total score significantly correlated with worse VAS (P<.001), SF-12 mental (P=.007), PDI total (P<.001), and SSS-8 (P<.001) scores. Only the PCS magnification subscore was significantly greater among patients who did (n=41) undergo surgery (P=.043). Those who had previously undergone foot and/or ankle surgery had significantly higher PCS rumination (=.012), magnification (=.006), helplessness (=.008), and total (=.003) scores. Likewise, those with a history of substance abuse also had significantly higher PCS scores (=.005; =.003; =.006; =.003).
The correlations between PCS scores and other baseline PROMs indicate that strong pain catastrophizers with PF or CAI may be at risk for poor treatment outcomes. PCS scores could be used to help with treatment for such high-risk patients.
疼痛灾难化量表（PCS）是衡量患者对疼痛情绪反应的一种方法。它由 3 个分量表组成——反刍、放大和无助，分别针对疼痛的侵入性思维、对负面结果的预期以及无法应对疼痛。我们的目的是比较足底筋膜炎（PF）或慢性踝关节不稳定（CAI）患者的基线 PCS 评分与其他基线患者报告的结局测量指标（PROMs）。
我们回顾性分析了 2015 年至 2020 年期间在一位 fellowship培训的足踝外科医生诊所就诊的至少有 1 个术前 PCS 分量表评分且被诊断为 PF 或 CAI 的 201 例患者。记录了患者的人口统计学资料、合并症、治疗方法、其他基线 PROMs（即视觉模拟量表[VAS]、疼痛残疾指数[PDI]、12 项简明健康调查量表[SF-12]、8 项躯体症状量表[SSS-8]）和术后结局。
PCS 总分及其分量表与每个 PROM 的总分和/或分量表显著相关。较高的 PCS 总分与更差的 VAS（P<.001）、SF-12 心理（P=.007）、PDI 总分（P<.001）和 SSS-8（P<.001）评分显著相关。只有接受手术的患者（n=41）的 PCS 放大分量表显著更高（P=.043）。既往接受过足踝手术的患者的 PCS 反刍（=0.012）、放大（=0.006）、无助（=0.008）和总分（=0.003）评分显著更高。同样，有药物滥用史的患者的 PCS 评分也显著更高（=0.005；=0.003；=0.006；=0.003）。
PCS 评分与其他基线 PROMs 之间的相关性表明，患有 PF 或 CAI 的强烈疼痛灾难化患者可能面临治疗结局不佳的风险。PCS 评分可用于帮助治疗此类高风险患者。
