Psychological factors in the chronicity of back pain: Impact on treatment engagement and disability

Background: There are well-established positive relationships between
psychological distress and chronic back pain and disability. However,
there is very limited research in relation to levels of psychological
distress and the effect it has on treatment engagement in those with
chronic back pain. Methods: 89 men and 112 women experiencing back pain
recruited via convenience sampling completed the Depression, Anxiety and
Stress Scale, Oswestry Low Back Pain Disability Questionnaire, the West
Haven-Tale Multidimensional Pain Inventory, and a demographic
questionnaire designed purposely for the study. Results: Depression,
anxiety, affective distress, and life control predicted the number of
treatments engaged in for back pain, (R2 = 0.29, [16,161] = 12.19, p =
.0005) and the level of disability, (R2 =.31, F[14,177] = 19.60, p =
.0005). Conclusions: The level of engagement in treatments was predicted
by psychological factors rather than by the level of pain experienced by
participants. The findings showed that participants who were
psychologically distressed, not only had higher levels of pain and
disability, but also engaged in fewer treatments.