Persistierende Schmerzen beeinflussen Menschen mit LBP in ähnlicher Weise

Study Design: A prospective cross-sectional design.

Objective: The objectives were to describe the occurrence and to investigate the association of the fear-avoidance model variables (pain intensity, kinesiophobia, depression, and disability) in patients with specific- or non-specific chronic low back pain (CLBP).

Summary of Background Data: Affective factors, particularly fear, have proven to be central in the explanation and understanding of chronic pain. The fear-avoidance model has shown that fearful patients with CLBP are at risk of becoming trapped in a vicious cycle of pain, fear, disability, and depressive symptoms. Little is known about the relationship between these factors in patients sub-grouped as specific- or non-specific CLBP.

Methods: All 147 patients (81 women, 66 men) were examined by an orthopaedic surgeon and diagnosed as either specific- or non-specific CLBP based on that examination. Hierachical multiple regression analysis was used to assess the ability of four independent variables (back pain intensity, VAS; kinesiophobia, TSK; depressed mood, Zung) to predict levels of disability, after controlling for the influence of age and gender.

Results: Both groups (specific- and non-specific CLBP) presented elevated values on the fear-avoidance model variables. All the independent fear-avoidance variables contributed in a statistically significant manner to predict disability in patients with specific CLBP, 67.0%, F (5, 59) = 24.46, p<0.000. In patients with non-specific CLBP, all variables except kinesiophobia predicted disability in a statistically significant manner, 63.0%, F (5, 59) = 22.64, p <0.000.

Conclusions: We conclude that persistent musculoskeletal pain affects the individual in a similar manner, regardless of the cause of the pain. In clinical terms, this means that pain must be analyzed and treated as a parallel process to searching for the cause of the pain.