Psychological factors significantly influences pain perception and function in individuals with low back pain

Abstract

Introduction: Pain perception varies with each individual and influences treatment outcome. Psychological acceptance and wellbeing may affect pain perception and hence functional capabilities of patients with chronic low back pain (LBP). The aim of study is to determine the impact of psychological factors on pain perception and function. Methodology: This was an assessment of a prospectively collected cohort of patients with chronic LBP enrolled in a 14-week rehabilitation programme. Functional and psychological assessments at baseline, 8-weeks and 14-weeks included Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Spinal Function Sort Score (SFSS), Acceptance of Illness Scale (AIS), Bradburn Affect Balance Scale (BABS) and Beck Depression Inventory (BDI). Results and Analysis: 191 patients were recruited. After the programme, patients reported significant improvement in SFSS. A significant improvement was observed in AIS and BABS. Patients however reported increased BDI, suggesting pervasive negative cognitions about their physical condition. An inverse correlation between change in AIS and change in VAS at rest (rs=0.19, p<0.05) and under exertion (rs=-0.28, p<0.05) was observed, suggesting patients’ attitude positively affects pain and physical performance. Similarly, change in BDI was found to correlate positively with VAS at rest (rs=0.22, p<0.05) and under exertion (rs=0.20, p<0.05). Change in AIS correlated inversely with change in ODI (rs=-0.33, p<0.05) while change in BDI positively correlated with change in ODI (rs=0.30, p<0.05). Discussion and Conclusion: The study found that acceptance of illness and lack of negative cognitions towards the injury correlated with less pain and disability. Targeted strategies at enhancing psychological acceptance may be as important as physical and functional rehabilitation.