Subjective suffering in patients with low back pain

Area of Science:

• Rheumatology and Musculoskeletal Diseases
• Pain Management
• Psychological Medicine

Background:

• Low back pain (LBP) is a widespread rheumatic and musculoskeletal condition.
• Patients with LBP frequently experience significant physical discomfort and functional limitations.
• Understanding the factors influencing functional disability in LBP is critical for effective management.

Purpose of the Study:

• To investigate the relationship between subjective suffering, illness perceptions, pain intensity, and psychological morbidity in LBP patients.
• To elucidate the direct and indirect effects of these factors on functional disability.
• To identify key mediators in the pathway to functional disability.

Main Methods:

• A cross-sectional study involving 125 patients undergoing physiotherapy.
• Utilized validated instruments: Illness Perception Questionnaire-Revised, Illness Subjective Suffering Inventory, Hospital Anxiety and Depression Scale, and Oswestry LBP Incapacity Questionnaire.
• Employed structural equation modeling to analyze relationships between variables.

Main Results:

• Subjective suffering fully mediated the link between emotional response/consequences and functional disability.
• Subjective suffering partially mediated the relationship between coherence and disability.
• Pain intensity and illness identity were the only factors with direct effects on functional disability.

Conclusions:

• Interventions for LBP should prioritize addressing subjective suffering to mitigate functional disability.
• Providing patients with information and fostering disease and pain acceptance are key strategies.
• Targeting subjective suffering offers a promising avenue for improving functional outcomes in LBP.