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ORIGINAL RESEARCH article
Front. Pain Res.
Sec. Neuropathic Pain
Volume 6 - 2025 | doi: 10.3389/fpain.2025.1554630
Perceived injustice and its relation to chronic pain outcome in Complex Regional Pain Syndrome and chronic musculoskeletal pain
Provisionally accepted
Corinna Baum 1 Cora Rebhorn 2
Anne Martinelli 1 Dorothee Heining 2 Sabine Weimert 2 Sandra Bücher 2 Livia Steenken 2 Sebastian Steinmetz 3
Frank Birklein 2
Violeta Dimova 2*- 1 Department of Psychology, Fresenius University of Applied Sciences, Frankfurt am Main, Germany
- 2 Department of Neurology, University Medical Center Mainz, Mainz, Germany
- 3 Department of Neuroradiology, Univeristy Medical Center, Mainz, Germany
Objectives: 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 regard-ing the severity of loss associated with blame, unfairness, and pain. We investigated injustice be-liefs in CRPS compared with chronic musculoskeletal pain (CMP), where previous evidence indi-cates clinical relevance for pain-related outcome in this patients’ group. The role of perceived injus-tice in relation to pain intensity and disability was tested through a mediation model including catastrophizing thoughts of pain.Methods: Patients with CRPS (mean age M = 50.9, SD = 13.8) and CMP (mean age M = 53.9, SD = 8.0 years) were enrolled at two independent specialized outpatient clinics. All patients completed question-naires on pain intensity, pain disability, and perceived injustice, levels of depression and pain catastrophizing. Results: 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.Conclusions: Perceived injustice influences especially pain intensity through pain catastrophizing. This interaction appear to be common for both pain syndromes.
Keywords: complex regional pain syndrome, Low Back Pain, Chronic Pain, Perceived injustice, pain catastrophiz-ing
Received: 02 Jan 2025; Accepted: 19 Mar 2025.
Copyright: © 2025 Baum, Rebhorn, Martinelli, Heining, Weimert, Bücher, Steenken, Steinmetz, Birklein and Dimova. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Violeta Dimova, Department of Neurology, University Medical Center Mainz, Mainz, Germany
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