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Chronic low back pain during COVID-19 lockdown: is there a paradox effect?

Aymeric Amelot1, Anais Jacquot2, Louis-Marie Terrier3

  • 1Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France. aymmed@hotmail.fr.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|November 3, 2021
PubMed

Insights

The COVID-19 lockdown impacted chronic low back pain (cLBP), with some patients improving due to reduced anxiety and at-home workouts. However, anxiety and medication influenced outcomes, highlighting the complex interplay of physical and emotional factors in cLBP management.

Area of Science:

  • Pain Medicine
  • Psychosomatic Medicine
  • Epidemiology

Background:

  • The COVID-19 pandemic and associated lockdowns significantly impacted global health, including chronic pain conditions.
  • Chronic low back pain (cLBP) involves substantial emotional and psychological components, making it particularly susceptible to pandemic-related stressors.

Purpose of the Study:

  • To investigate the effects of the COVID-19 lockdown on patients with chronic low back pain (cLBP).
  • To identify prognostic factors influencing cLBP improvement or worsening during the lockdown period.

Main Methods:

  • A prospective study involving 50 patients with cLBP.
  • Collected pre- and 1-month post-lockdown data using validated questionnaires: Impact of Event Scale (IES), Oswestry Disability Index (ODI), Roland-Morris Questionnaire (RMQ), and Visual Analogue Scale (VAS).

Main Results:

  • 18% of patients improved (i-cLBP), while 14% worsened (w-cLBP).
  • MODIC 1 disc disease and at-home workouts were positive prognostic factors for cLBP improvement.
  • Subclinical/mild COVID-19 anxiety was a negative prognostic factor, whereas severe anxiety correlated with cLBP improvement.
  • Pre-lockdown benzodiazepine use was a negative prognostic factor for cLBP outcomes.

Conclusions:

  • The lockdown's physical restrictions negatively affected the somatic aspects of cLBP.
  • Paradoxically, the pandemic context, particularly severe anxiety, appeared to improve the psychic and emotional components of cLBP for some patients.
Abstract

Keywords:
AnxietyCOVID-19Chronic low back painContainmentPain

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