Racial Differences in Movement-Related Appraisals and Pain Behaviors Among Adults With Chronic Low Back Pain

Area of Science:

• Pain Management
• Health Disparities
• Psychology

Background:

• Chronic low back pain (CLBP) disproportionately affects racial minorities.
• Limited research explores racial disparities in pain appraisals and behaviors among CLBP patients.
• Anticipatory and movement-related pain appraisals are crucial in CLBP but understudied across racial groups.

Purpose of the Study:

• To investigate racial differences in anticipatory pain appraisals, fear of harm, and anxiety before movement.
• To examine racial variations in pain and anxiety appraisals during functional activities.
• To observe and compare racial differences in pain behaviors during daily living tasks in CLBP individuals.

Main Methods:

• Cross-sectional study of 126 individuals with CLBP: Non-Hispanic White (38.9%), Non-Hispanic Black (31.0%), and Hispanic (30.2%).
• Assessed anticipatory appraisals (expected pain, harm concerns, pre-movement anxiety) before three tasks.
• Measured appraisals of pain and anxiety during tasks and observed pain behaviors (e.g., verbalizations).

Main Results:

• Hispanic participants reported higher expected pain, harm concerns, and pre-movement anxiety than Non-Hispanic White participants for bed and chair tasks.
• Hispanic and Non-Hispanic Black participants reported greater anxiety during movement tasks compared to Non-Hispanic White participants.
• Non-Hispanic Black participants exhibited more verbalizations of pain during a bed task compared to Non-Hispanic White participants.

Conclusions:

• Significant racial disparities were found in cognitive-behavioral and fear-avoidance mechanisms related to CLBP.
• Findings highlight the need to integrate racial considerations into theoretical and treatment models for CLBP.
• Addressing racial variations in pain cognitions is essential for effective CLBP management.