The role of pain cognitions in healthcare utilization in patients undergoing surgery for lumbar radiculopathy: A multicenter randomized controlled clinical trial

The project aims at investigating the role of pain cognitions in determining healthcare utilization in patients undergoing surgery for lumbar radiculopathy. Although, surgeries being anatomically successful, 23-28% of the patients ends up having chronic spinal pain, leading to higher levels of healthcare use and absenteeism, which results in high socio-economic burden. The evidence about associations between pain cognitions and healthcare utilization in other patient populations supplemented with our preliminary data about this relationship and the fact that maladaptive pain cognitions are present in subgroups of patients with lumbar radiculopathy, indicate the relevance and importance of this proposal. Unraveling the mechanism behind healthcare use will make it possible to implement therapeutic interventions to keep healthcare utilization to the appropriate level. First, associations between pain cognitions and healthcare utilization in patients with lumbar radiculopathy will be further explored. Second, causal interactions can be revealed by studying whether improvements in pain cognitions lead to lower levels of healthcare utilization in patients undergoing surgery for lumbar radiculopathy. Therefore, patients will be randomized to either a treatment targeting pain cognitions or a treatment not taking pain cognitions into consideration.