The Role of Pain Catastrophizing in the Prediction of Acute and Chronic Postoperative Pain

Ran Kremer, Michal Granot, David Yarnitsky, Yonathan Crispel, Shiri Fadel, Lael Anson Best, Rony Reuven Nir

Research output: Contribution to journalArticlepeer-review


Background and Objectives: Despite the established association between greater pain catastrophizing and enhanced postoperative pain, it is still unclear: (i) what is the relative contribution of each of the pain catastrophizing scale (PCS) dimensions in the prediction of acute and chronic postoperative pain; and (ii) whether PCS scores mediate the association between acute and chronic postoperative pain intensity. Methods: The current prospective, observational study was conducted at Rambam Health Care Campus, Haifa, Israel. PCS was obtained in 48 pain-free patients a day before an elective thoracotomy in response to tonic heat pain. Acute postthoracotomy pain (APTP) was assessed during rest, including general pain (Restgeneral), and incision-related pain (Restincision), and in response to provoked physical activity, including hand elevation (Provokedhand) and cough (Provokedcough). Chronic postthoracotomy pain (CPTP) was assessed after 4.5±2.3 months. Results: Of the PCS subscales, only rumination: (i) was correlated with Restgeneral scores (r=0.337, P=0.027); and (ii) predicted chronic postthoracotomy pain in a regression analysis (P=0.001). General PCS and its subscales mediated the correlation between Restgeneral and chronic postthoracotomy pain intensity (Ps<0.006). Conclusions: Findings may elucidate the unique role of the rumination subscale in reflecting an individual's postoperative acute and chronic pain responsiveness. The transition from acute to chronic postoperative pain seems to be facilitated by enhanced pain catastrophizing.

Original languageEnglish
Pages (from-to)176-182
Number of pages7
JournalOpen Pain Journal
Issue number1
StatePublished - 2013


  • Acute postoperative pain
  • Chronic postoperative pain
  • Mediation analysis
  • Pain catastrophizing
  • Postoperative pain

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Anesthesiology and Pain Medicine


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