Understanding Psychological factors In Relation To Chronic Low Back Pain- A Review Study (original) (raw)
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Psychological Aspects of Chronic Low Back Pain: A Review
Objective: To review the relationships between chronic low back pain (CLBP) and psychopathology in the light of relevant literature and to help clinicians more easily assess and treat this common disabling condition. Method: Recent literature was investigated using the online Web databases Medline/PUBMED, Proquest and Science Direct from 1990 to the present (2007). Of over 250 articles searched, 124 selected on their relevance to the chronic low back pain states. Results: The relationship between chronic pain and psychopathology has generated substantial empirical and theoretical interest, with depressive disorders receiving much of the attention. Although no single theoretical model can fully explain the causal relationship between CLBP and psychopathology, diathesis-stress model and fear avoidance model are emerging as the dominant overarching theoretical perspectives. Conclusion: Evaluation of psychopathology may help foreseeing the functional outcome of the patient and unwanted treatment outcomes because unrecognized and untreated psychopathology can significantly interfere with both successful surgical treatment and subsequent rehabilitation of the patients suffering with CLBP. It seems that cognitive-behavior therapy (CBT) should be an essential part of the multidisciplinary treatment for patients with chronic low back pain.
Psychological Profile of Patients with Chronic Low Back Pain
Journal of Gandhara Medical and Dental Science, 2021
OBJECTIVES: To assess the frequency of depression, anxiety, and stress in patients with Chronic Low Back Pain (CLBP) using Depression Anxiety Stress Scale (DASS-42). METHODOLOGY: This descriptive study was performed from January 2019 to June 2019. All those patients with chronic low back pain with duration of more than 6 months were included. Patients below 20 and above 60 years were excluded to eliminate the effect of extreme ages. The Depression Anxiety Stress Scale (DASS-42) was used in this study. RESULTS: In this study, a total of 127 patients were successfully interviewed. The mean age of the sample was 36.46 (SD±7.38) with a minimum age of 22 years and maximum of 59 years. Out of these 127 patients, 83 (65.4%) were female while 44 (34.6%) were male patients. The minimum duration of chronic low back pain in our patients was 8 months while the maximum was 55 months with a mean of 28 months (SD 9.9). The mean DASS score for depression was 11.8 (SD±4.23), anxiety was 7.5 (SD±2.9)...
Conceptual overlap of psychological constructs in low back pain
Pain, 2013
The biopsychosocial model is increasingly accepted in low back pain (LBP) research and clinical practice. In order to assess the role of psychological factors in the development and persistence of pain, a wide array of measures has been developed. Yet there is likely to be considerable conceptual overlap between such measures, and consequently, a lack of clarity about the importance of psychological factors. The aims of this study were to investigate the extent of any such overlap. An observational cohort study of 1591 LBP patients consulting in primary care completed data on a range of psychological instruments. Exploratory and confirmatory factor analyses (EFA and CFA, respectively) were carried out at the subscale level (n = 20) to investigate factor structure. The influences of the derived factors on clinical outcomes (pain intensity and self-reported disability) were then tested using linear regression. EFA yielded 4 factors, termed ''Pain-related distress,'' ''Cognitive coping,'' ''Causal beliefs,'' and ''Perceptions of the future,'' which accounted for 65.5% of the variance. CFA confirmed the validity of these factors models. The painrelated distress factor was found to have the strongest association to LBP patients' outcomes, accounting for 34.6% of the variance in pain intensity, and 51.1% of the variance in disability. Results confirmed that considerable overlap exists in psychological measures commonly used in LBP research. Most measures tap into patients' emotional distress. These findings help us to understand how psychological constructs relate together; implications for future research and clinical practice are discussed.
CHRONIC LOW BACK PAIN& PSYCHOLOGICAL COMORBIDITY
International Journal of Development Research, 2019
Aim:Low back pain is a common disease, and it is observed at least once in 70-85% of the population during their lifetime.Chronic low back pain (CLBP)interferes with the physical ability and mobility of high number of people. This study will determine if there is a relationship between mental disorders including depression, hypochondriasis and anxiety, and the functional status of patients suffering from chronic low back pain.Subjects and methods: The study was performed on a sample of 200 agreed to participate in this cross-sectional study. The patients were divided equally into two separate groups: first group consisted patients with chronic low back pain with clear organic lesion and validated radiologically.The second group consisted of patients with chronic low back pain in which no clinical and radiological confirmation for an organic lesion, or called functional group. Every patient has undergone to the following procedures: A) Medical evaluation including (Neurological evaluation, systemic examination mainly gynecological examination in all female patients and radiological examination mainly Plain x-ray of lumbosacral spine and Magnetic Resonence Imaging(MRI) lumbosacral spine. B) The psychological evaluation used to measure anxiety, depression and hypochondriasis by adopting the MMPI Questionnaire Results: This study sample has included 53% males and 47% females in organic group while 30% males and 70% females in functional group. In Organic group, age and LBPwere found to be significantly associated. Radiation was absent in 9% of patients in organic group and in 60% of patients in functional group. Parathesia present in 85% of organic group, while functional group 20%. 70% of those in organic group and 25% of those in functional group reported severe pain.Depressionwas observed in 15% oforganic group participants and in 35% of patients of functional group in LBP patients. Depression scores reported in the functional group are strikingly higher than that inthe group with organic lesion.Anxiety were (14%) in organic group, 20% in functional group, hysteria scores in the second group are decidedly higher than that in the group with organic lesions. Hypochondriasis disorders reported in 9.5%of organic pain patients and in 15% of functional pain group.Hypochondriasis scorewas found to be definitely higher in the functional groupthan in the organic group.Conclusion: Depression, anxiety, and hypochondriasis are highly prevalent among people with chronic low back pain. So in order to manage the pain, it is useful to treat patient’s mental dysfunctions that will probably improve their functional status. This way, patients can avoid addictive management and treatment regimens prescribed by their physician to treat their functional disabilities.
Psychosocial issues in the prevention of chronic low back pain--a literature review
Baillière's clinical rheumatology, 1992
This chapter has reviewed research on psychological and social factors associated with the onset and progression of low back pain. From this review it can be concluded that psychosocial traits appear to be important contributors to the course of pain and disability though methodologically well-designed longitudinal studies are rare. For this reason it is difficult to assess the relative importance of, for example, psychological distress compared with work stress. Furthermore, the mechanisms by which specific variables effect back pain remain unknown. The answer, no doubt, lies in longitudinal studies which employ multicausal models. It has been noted the psychosocial treatments which have proven effective for chronic pain populations are rarely assessed with acute pain patients. Some problems are the inaccessibility of acute back pain sufferers to psychologists, the difficulty of isolating the effect of one component of a multidisciplinary programme and the lack of uniform practice ...
Pain, 1981
The principal dimensions of the pain experience of 102 patients with chronic low back pain were studied and components of the pain experience were compared to pretreatment measures of emotional disturbance. Responses on the McGill Pain Questionnaire (MPQ) were factor analyzed revealing dimensions of the pain experience that seemed to represent sensory, affective, and evaluative aspects. Patients with high scores on the MMPI hypochondriasis scale portrayed their pain as more intense and as high in terms of affective and evaluative descriptors on the MPQ. Other MMPI scales reflecting emotional disturbance (depression, hysteria) were also associated with a more intense description of pain and higher scores on an affective descriptor dimension. The evaluative descriptive dimension was highly related to the overall intensity of the pain experience. Only the affective dimension was related to emotional disturbance separately from the effects of intensity alone.
Journal of Clinical Psycology, 2011
Introduction: Chronic low back pain (CLBP) is one of the most common and challenging manifestations of pain in adults. Meanwhile psychological factors are considered important in development and continuing of physical disability and functional limitations of patients with CLBP. The aim of this research was to determine the psychological factors related to physical disability in patients with CLBP. Method: The present study having a cross-sectional design and was from type of correlational which 279 (81 men, 198 women) eligible CLBP patients more than 3 months (with the mean age 42.44 ±11.77 yr) which patients were refered to Specialized and sub-specialized Neurosurgery Clinic of Poorsina Hospital in Rasht were selected by non probability and consecutive sampling. All patients completed questionnaire of demographic and related low back pain information at the beginning and then they were evaluated by Roland-Morris Disability Questionnaire (RDQ), Visual Analog Scale (VAS), Tampa Scale for Kinesiophobia (TSK), coping strategies questionnaire, catastrophizing subscale (CSQ-CAT), Stanford Depression Scale (CES-D 10) and pain self-efficacy scale. Results: Correlational analyses indicating significant association between physical disability and all predictive factors. The results of stepwise multiple regression analysis showed that psychological factors significantly explained 52% of the variance of physical disability. In the full model higher levels of self-efficacy beliefs, pain intensity, education, and pain-related fear the composite score of values gained from the two scales of catastrophizing and Kinesiophobia, significantly contributed to the prediction of higher levels of physical disability. Conclusion: The findings showed that, regardless of demographic factors, there is a relatively strong relationship between psychological factors and disability. Thus, clinicians must be aware of the powerful effects of self-efficacy, pain-related fear, pain intensity and patient awareness of the health of their spine to reduce disability and managing CLBP patients. Some clinical implications and research guidelines obtained from these results are discussed for prevention and control of physical disability in these patients.
Emotional and disability status in patients with chronic low back pain
International Journal of Radiology & Radiation Therapy, 2020
Objective: to analyze the prevalence of psychological disorders (anxiety, depression, stress) and the relationship of these factors with functional disability in patients with chronic low back pain. Study design: cross-sectional descriptive and observational study. Setting: the physiotherapy outpatient clinic of the Northen University of Paraná, Londrina, Paraná, Brazil. Methods: 84 individuals were recruited, being 43 elderly (20 with low back pain and 23 control subjects) and 41 adults (21 with low back pain and 20 control subjects). In order to assess the psychological aspects, Beck Inventories of Depression and anxiety as well as Lipp Stress Inventory were used. To evaluate the funcionality, Roland Morris Questionnaire was chosen. The evaluation of the pressure pain threshold was performed using algometer emg systems®. To analyse was considered a significance level of 5% (p<0.05). Results: It was observed that people with low back pain have higher scores of depression, anxiet...