Pain perception patterns are strongly associated with kinesiophobia in patients with dyssynergic defecation: a cross-sectional study

Purpose Dyssynergic defecation (DD) is a functional defecation disorder marked by impaired abdominopelvic muscle coordination and often accompanied by pain and psychological factors, yet the role of kinesiophobia in DD remains unclear. This study aimed to assess the prevalence of kinesiophobia in patients with DD and to investigate its associations with pain, clinical severity, and psychological factors.Methods In this prospective cross-sectional study, 120 adults with DD were evaluated using the Visual Analog Scale (VAS) for pain during and after defecation, Tampa Scale for Kinesiophobia (TSK), Constipation Severity Instrument (CSI), Pain Catastrophizing Scale (PCS), Constipation Quality of Life Questionnaire (PAC-QoL), and Beck Depression Inventory (BDI). Pearson correlation analyses, ROC curve analyses, and multivariate regression were performed.Results Kinesiophobia was highly prevalent (over 90%) with no gender differences. TSK scores were significantly correlated with pain intensity, constipation severity, pain catastrophizing, depressive symptoms, and reduced quality of life (p < 0.01). ROC analyses identified VAS thresholds >6 during and >4 after defecation for discriminating kinesiophobia. Regression analysis explained 71% of TSK variance, with PCS as the strongest predictor.Conclusion Kinesiophobia is common in DD and closely associated with pain perception and psychological distress. Addressing maladaptive pain-related cognitions may improve DD management.