Among people with a non-traumatic lower extremity condition, is pain in the contralateral lower extremity associated with unhelpful thoughts and distress regarding symptoms?

Objective: When patients with non-traumatic lower extremity conditions express concerns regarding symptoms of the contralateral lower extremity they may be communicating fear of painful movement. Among people seeking specialty care for unilateral non-traumatic lower extremity conditions, we studied the relationship between magnitude of incapability and pain intensity in the contralateral and ipsilateral limbs and thoughts and feelings about sensations. Methods: Patients seeing a musculoskeletal specialist for any unilateral non-traumatic lower extremity condition were enrolled. We used multivariable analysis to identify aspects of unhelpful thinking and feelings of distress associated with contralateral and ipsilateral pain intensity and magnitude of capability accounting for demographic factors. Results: Greater pain intensity in the contralateral limb, greater pain intensity in the ipsilateral limb, and higher magnitude of incapability were all associated with greater distress regarding symptoms. Conclusions: When patients voice concerns about pain in the contralateral limb, they may be signaling feelings of worry or despair regarding symptoms. Practice implications: Concerns about pain in the contralateral limb can prompt clinicians to explore feelings of worry or despair regarding symptoms, an important and modifiable aspect of musculoskeletal illness.