Some Factors Associated with the Report and Evaluation of Back Pain

Abstract

Back pain is a frequent cause of personal distress, use of health care resources, and work disability. It is commonly difficult for physicians to find a medical explanation for the severity of pain and disability associated with back complaints. Using data from The United States Health and Nutrition Examination Survey (HANES), we examined factors associated with complaints of back pain among a subsa !ple of 2,431 respondents relative to physician findings. We constructed an index that depicts the extent to which complaints of back pain exceed physician findings. Consistent with studies of health perceptions, older persons and those reporting greater psychological well-being were less likely to make invalidated complaints, controlling for other factors. Depressed mood was associated with both more complaints and more physical findings, suggesting that it was in part a consequence of back difficulties. The inclination of older persons to report less pain at comparable levels of physical findings was significant only among persons with higher levels of well-being. Distress, we believe, affects perceptions of pain and overall health because such complaints are cognitively structured in relative terms within particular social contexts.