Évaluation psychocomportementale dans la lombalgie chronique

Abstract

Introduction Psychobehavioural assessment may be a complementary approach to assess response to treatment for pain and disability in patients with low back pain. Objectives To assess the correlation between psychobehavioural factors and pain and disability in patients with chronic low back pain in France. Methods We asked 83 patients with chronic low back pain to complete questionnaires during a primary care consultation by a general practitioner. Pain was measured by a visual analog scale (VAS), disability by the Quebec Back Pain Disability Scale and psychobehavioural factors by the Fear–Avoidance Beliefs Questionnaire (FABQ) and the Coping Strategy Questionnaire (CSQ). Results Pain was poorly correlated with anxiety ( R = 0.36) and scores on the FABQ 1 ( R = 0.46) and FABQ 2 ( R = 0.30) and not correlated with depression ( R = 0.22), duration of pain evolution ( R = 0,10) and body mass index ( R = 0.12). The duration of stopping work was poorly correlated with disability ( R = 0.35) and FABQ 1 score ( R = 0.43) and not correlated with pain ( R = 0.11), anxiety ( R = 0.11), depression ( R = 0.26) and FABQ 2 score ( R = 0.23). Disability was poorly correlated with scores on the FABQ 1 ( R = 0.45) and FABQ 2 ( R = 0.3), anxiety ( R = 0.39) and depression ( R = 0.47) and not correlated with pain ( R = 0.25). Dramatization is the only way to cope with pain and was correlated with pain ( R = 0.34), scores on the FABQ 1 ( R = 0.47) and FABQ 2 ( R = 0.43), disability ( R = 0.38), anxiety ( R = 0.44) and depression ( R = 0.46). The use of prayer was poorly correlated with FABQ 1 score ( R = 0.37) and anxiety ( R = 0.30). Distraction was poorly correlated with scores on the FABQ 1 ( R = 0.40) and FABQ 2 ( R = 0.30). No strategy was correlated with duration of pain and stopping work. Discussion–conclusion All the correlation assessments with psychobehaviour factors are weak. So evaluating each of these parameters will be interesting. Duration of pain was not correlated with increasing pain or change in behavioural strategy. Psychobehavioural factors are more invalidating than pain. More study is needed to assess psychobehavioural therapies in patients with low back pain.