The Correlation Between Pain, Catastrophizing, and Disability in Subacute and Chronic Low Back Pain

Abstract

[EN] Study Design.

Correlation between variables mea­sured with previously validated instruments. Objective.

To explore the association between cata­strophizing and disability in patients treated for subacute or chronic low back pain (LBP) within routine clinical prac­tice in Spain. Summary of Background Data.

The influence of psy­chological variables on LBP-related disability in Southern Europe is different to the one in the Anglo-Saxon and Northern European cultural environments. In Spanish LBP patients, the influence of fear avoidance beliefs on disability is negligible, and catastrophizing does not me­diate the improvement of disability caused by active ed­ucation. The association between catastrophizing and dis­ability is unknown. Methods.

Thirty-three clinicians working for the Spanish National Health Service in 6 primary care and 8 specialty centers, recruited 1461 patients seeking care for subacute and chronic LBP. Patients were assessed only once. A linear regression model was developed to assess the percentage of the variance of disability ex­plained by gender, age, chronicity status, severity of LBP, severity of referred pain (referred pain down to the leg), catastrophizing, eligible for workers’ compensa­tion (yes/no), failed back surgery (yes/no), radiologic findings, and treatments. Results.

Correlations among LBP, referred pain down to the leg, disability, and catastrophizing were moderate, but significant. The strongest one was between disability and catastrophizing (r ∇ 0.520). Catastrophizing explained 28% of disability, whereas severity of LBP only 3%. Global adjusted R2 of the model was 0.387. There was an asso­ciation between some radiologic findings and treatments, and slightly higher levels of disability. Conclusion.

In Southern European subacute and chronic LBP patients, catastrophizing correlates with dis­ability and explains approximately one-fourth of its vari­ance. Further studies should assess its value as a prog­nostic factor in subacute and chronic patients.