DETERMINATION OF EMOTIONAL AND BEHAVIORAL FACTORS ASSOCIATED WITH PAIN SEVERITY IN PATIENTS WITH CHRONIC LOW BACK PAIN

Abstract

OBJECTIVE: The primary aim of the study was to determine which emotional and behavioral factors affect the pain severity and to what extent in patients with chronic low back pain (LBP). MATERIAL AND METHODS: One hundred and seventy-eight patients with LBP participated in the cross-sectional study. The primary outcome was the Visual Analog Scale (VAS) evaluated the pain severity during rest (VASrest) and activity (VASact). Secondary outcomes included the Pain Beliefs Questionnaire (PBQ), The Pain Coping Questionnaire (PCQ) and The Fear-Avoidance Beliefs Questionnaire (FABQ). RESULTS: While PBQ scores increased, VASrest and VASact scores decreased significantly (p< 0.05). There was a positive and significant correlation between VASrest and only Medical Remedies Subparameter of PCQ(p=0.008), and between VASactivity and only Helpless Subparameter of PCQ (p<0.05). VASrest and VASact had positive and significant associations with FABQ scores (p< 0.05). The results of the regression analysis showed that pain-related psychologic beliefs are the main determinants of VASrest(p=0.014) and VASact (p=0.006). Pain related organic beliefs had a significant but lower effect on VASrest (p=0.019) and VASact (p=0.031). It was observed that seeking a medical remedy for pain at rest had a significant effect on reducing the VAS scores(p=0.024). CONCLUSIONS: Inadequacies in the management of negative beliefs associated with pain contribute to the exacerbation of pain even at rest. However, neither fear avoidance behavior nor coping strategies except medical remedies developed for pain at rest do not reduce pain severity.