Pain intensity did not contribute to the final model. The interpretation of this result may be that pain intensity plays a more important part in the acute situation, whereas chronic pain is modi- fied by several factors, masking the relationship to hyperalgesia and other neuropathic symptoms. Reduced function, as evaluated by FIQ, was asso- ciated with a higher number of neuropathic symp- toms in the present study, but outweighed by emotional distress and the diagnosis of fibromyal- gia. The present patients reported elevated levels of emotional distress, and the most prominent feature was somatization. Cutoff of the subscales in HSCL-25 has, to our knowledge, not been reported and validated, but depression was reported at a significantly lower level than soma- tization. We also evaluated depression by FIQ, which had a sufficiently low correlation to emo- tional distress to be included in the analysis. No separate contribution of this factor was found. The major predictor of neuropathic symptoms in the present study was emotional distress. Emotional distress is a well-known predictor of chronic pain [20] and is related to sensory changes and altered nociceptive processing [4]. Sensory symptoms adding to pain are associated with poor recovery [37]. In order to plan effective intervention, it is important to establish a cause–effect relationship between emotional distress and the sensitization process, and to clarify the mechanisms involved.