The majority of the studies aimed at identifying factors which had a negative influence on the onset and recovery of musculoskeletal pain. The authors found evidence that among others fear, depression, distress, catastrophising, poor (mental) health and a bad sleep pattern may accelerate the development of musculoskeletal pain and hinder recovery.
In only 12 of the 59 studies researchers investigated protective psychological factors. The authors found evidence that five factors are able to decrease the probability of persistent musculoskeletal pain: active coping strategies, a positive expectation about the recovery, good self-efficacy and a subjective good (mental) health.
Multiple research groups investigated whether anxiety, personal traits, wellbeing, pain control and willingness to change influenced musculoskeletal pain. The authors concluded, however, that based on their analysis, there is no evidence that these factors have either a protective or a hindering effect. In their discussions, the authors do provide advice regarding the most appropriate measurement instruments to assess psychological factors in patients with musculoskeletal pain (see frame).