Understanding the Link between Low Back Pain and Distress

Researchers know that low back pain (LBP) is often linked with anxiety or depression. The relationship is especially strong in patients whose LBP doesn't get better. No one is exactly sure how this relationship works. Does the pain and inactivity of LBP cause anxiety and depression? Or does anxiety and depression set patients up for low back pain? The answer probably depends on the patient. But either way, it has become clear that doctors and therapists must deal with the psychological distress associated with LBP in some patients.

These authors in England questioned more than 200 patients with recurring LBP who were referred for physical therapy. The authors used a standard survey for rating distress in LBP patients. They found that one-third of the patients showed significant signs of distress. And earlier research shows that these patients have three to four times as many poor outcomes after treatment as LBP patients who have lower levels of distress.

The authors conclude that all health care professionals, especially doctors and physical therapists, need to be aware of the psychological needs of their patients with LBP. Most importantly, health care workers then need to help their patients get the care they need to shake the blues--and their LBP.

Melinda C. Cairns, PhD, et al. Level of Distress in a Recurrent Low Back Pain Population Referred for Physical Therapy. In Spine. May 1, 2003. Vol. 28. No. 9. Pp. 953-959.

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