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

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.