Abstract
BackgroundUtilizing psychological resources when dealing with chronic low back pain might aid the prevention of disability. The observational study at hand examined the longitudinal impact of resilience and coping resources on disability in addition to established risk factors.MethodsFour hundred eighty four patients with chronic low back pain (>3 months) were recruited in primary care practices and followed up for one year. Resilience, coping, depression, somatization, pain and demographic variables were measured at baseline. At follow-up (participation rate 89%), data on disability was collected. We first calculated bivariate correlations of all the predictors with each other and with follow-up disability. We then used a multiple regression to evaluate the impact of all the predictors on disability together.ResultsMore than half of the followed up sample showed a high degree of disability at baseline (53.7%) and had suffered for more than 10 years from pain (50.4%). Besides gender all of the predictors were bivariately associated with follow-up disability. However in the main analysis (multiple regression), disability at follow up was only predicted by baseline disability, age and somatization. There was no relationship between resilience and disability, nor between coping resources and disability.ConclusionsAlthough it is known that there are cross-sectional relationships between resilience/coping resources and disability we were not able to replicate it in the multiple regression. This can have several reasons: a) the majority of patients in our sample were much more disabled and suffered for a longer time than in other studies. Therefore our results might be limited to this specific population and resilience and coping resources might still have a protective influence in acute or subacute populations. b) We used a rather broad operationalization of resilience. There is emerging evidence that focusing on more concrete sub facets like (pain) self-efficacy and acceptance might be more beneficial.Trial registrationGerman Clinical Trial Register, DRKS00003123 (June 28th 2011).
Highlights
Utilizing psychological resources when dealing with chronic low back pain might aid the prevention of disability
We included all patients with persistent chronic low back pain (CLBP) or those shifting from CLBP into chronic widespread pain (CWP) in the analysis (n = 423)
The results of this study suggest that neither resilience nor coping resources can act as predictors for favourable courses of disability in CLBP patients
Summary
Utilizing psychological resources when dealing with chronic low back pain might aid the prevention of disability. In a German study based on the general population, about 16% of individuals with pain reported high levels of disability [1]. Less is known about protective factors possibly leading to favourable courses of back pain. This is especially important since the mere absence of risk factors does not predict successful adaptation to chronic pain [8]. Focusing on constructs from positive psychology such as resilience or coping resources might identify protective factors which can be implemented in the management of chronic pain and promote successful adaptation [10]
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