Baum Corinna, Rebhorn Cora, Martinelli Anne, Heining Dorothee, Weimert Sabine, Bücher Sandra, Steenken Livia, Steinmetz Sebastian, Birklein Frank, Dimova Violeta
Department of Psychology, Fresenius University of Applied Sciences, Frankfurt, Germany.
Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Front Pain Res (Lausanne). 2025 Apr 3;6:1554630. doi: 10.3389/fpain.2025.1554630. eCollection 2025.
Clinical observations indicate that patients with complex regional pain syndrome (CRPS) tend to ruminate about their illness. Perceived injustice is a negative cognitive-emotional appraisal regarding the severity of loss associated with blame, unfairness, and pain. We investigated injustice beliefs in CRPS compared with chronic musculoskeletal pain (CMP), where previous evidence indicates clinical relevance for pain-related outcome in this patients' group. The role of perceived injustice in relation to pain intensity and disability was tested through a mediation model including catastrophizing thoughts of pain.
Patients with CRPS (mean age = 50.9, = 13.8) and CMP (mean age = 53.9, = 8.0 years) were enrolled at two independent specialized outpatient clinics. All patients completed questionnaires on pain intensity, pain disability, and perceived injustice, levels of depression and pain catastrophizing.
CRPS patients displayed higher levels of perceived injustice than the CPM patients. Higher pain intensity in both cohorts was indirectly associated with more feelings and beliefs of injustice through a higher tendency to catastrophize about pain and pain-related information. In contrast, only in the CMP group higher pain-related disability was related to higher catastrophizing, which mediated the effect of perceived injustice.
Perceived injustice influences especially pain intensity through pain catastrophizing. This interaction appears to be common for both pain syndromes.
临床观察表明，复杂性区域疼痛综合征（CRPS）患者往往会反复思考自己的病情。感知到的不公正感是一种对与责备、不公平和疼痛相关的损失严重程度的负面认知-情绪评估。我们将CRPS患者与慢性肌肉骨骼疼痛（CMP）患者的不公正信念进行了调查，先前的证据表明，这种不公正信念与该患者群体中与疼痛相关的结果具有临床相关性。通过一个包括疼痛灾难化思维的中介模型，测试了感知到的不公正感与疼痛强度和残疾之间的关系。
在两家独立的专科门诊招募了CRPS患者（平均年龄=50.9，=13.8）和CMP患者（平均年龄=53.9，=8.0岁）。所有患者均完成了关于疼痛强度、疼痛残疾、感知到的不公正感、抑郁水平和疼痛灾难化的问卷调查。
CRPS患者的感知到的不公正感水平高于CMP患者。两个队列中较高的疼痛强度通过对疼痛和与疼痛相关信息进行灾难化的更高倾向，间接地与更多的不公正感和信念相关。相比之下，只有在CMP组中，较高的与疼痛相关的残疾与更高的灾难化相关，而灾难化介导了感知到的不公正感的影响。
感知到的不公正感尤其通过疼痛灾难化影响疼痛强度。这种相互作用在两种疼痛综合征中似乎都很常见。
