This cross-sectional study explored associations between demographics, pain intensity and cognitions on the one hand and healthcare use (HCU) on the other hand in people undergoing surgery for lumbar radiculopathy. HCU during the 2 months preceding surgery was evaluated using a retrospective questionnaire. Demographics included sex, age and level of education and equivalent income. Back and leg pain intensity were evaluated using a visual analogue scale. Pain cognitions were assessed with the Tampa scale of kinesiophobia, the pain catastrophizing scale and the pain vigilance and awareness questionnaire. The sample comprised 120 participants (52% males; 49 years (Quartile (Q)1-Q3: 37.3-57.43)). The number of visits to the general practitioner was associated with sex (incidence rate ratio (IRR) for males = 0.811; p = 0.050), pain catastrophizing (IRR = 1.010; p = 0.041), pain magnification (IRR = 1.058; p = 0.004) and leg pain intensity (IRR = 1.004; p = 0.038). The number of neurosurgeon visits was associated with level of education (IRR moderate education = 1.518; p = 0.016 (reference: low education)). Receiving zero physiotherapy visits was associated with higher back pain intensity (Beta = 0.018; p = 0.028). Highest level of analgesics used was associated with sex (IRR for males = 0.502; p = 0.047) and leg pain (IRR = 1.014; p = 0.034). Only the association between general practitioner visits and pain magnification remained significant in multivariable analyses (IRR = 1.061; p = 0.033). The results suggest a rather indirect relationship between HCU and demographics, pain intensity and cognitions, involving a potential interplay between several patient- and healthcare system-related factors.

Original languageEnglish
Article number388
Number of pages14
JournalJournal of clinical medicine
Issue number1
Publication statusPublished - 3 Jan 2023

Bibliographical note

Funding Information:
W.V.B., L.G. and A.M. are currently research fellows of the Research Foundation Flanders (FWO), Belgium. E.H. was a research fellow of the Research Foundation Flanders (FWO), Belgium, during the course of the study. J.N. is holder of a chair at the Vrije Universiteit Brussel, funded by the Berekuyl Academy, Hardewijk, The Netherlands. JN and the Vrije Universiteit Brussel received lecturing/teaching fees from various professional associations and educational organizations outside of the submitted work. M.M. received speaker fees from Medtronic and Nevro outside of the submitted work. STIMULUS received independent research grants from Medtronic.

Funding Information:
This research was funded by the Applied Biomedical Research Program, Institute for the Agency for Innovation by Science and Technology, Belgium (IWT-TBM project No. 150180) and the Research Foundation Flanders (FWO), Belgium (1108619N & 1108621N). The funding bodies had no influence on the execution or results of the study, nor in the writing process of this manuscript.

Publisher Copyright:
© 2023 by the authors.

Copyright 2023 Elsevier B.V., All rights reserved.


  • age
  • analgesics use
  • healthcare use
  • healthcare visits
  • lumbar radiculopathy
  • pain intensity
  • sex
  • socio-economic status
  • surgery


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