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. 2019 Dec 17:12:3343-3353.
doi: 10.2147/JPR.S223190. eCollection 2019.

Emotional Effects on Factors Associated with Chronic Low Back Pain

Koichi Ouchi  1 , Mayumi Watanabe  2   3   4 , Chikako Tomiyama  5 , Takuya Nikaido  6 , Zaigen Oh  2 , Toru Hirano  7 , Kohei Akazawa  1 , Nozomu Mandai  3
Affiliations

Emotional Effects on Factors Associated with Chronic Low Back Pain

Koichi Ouchi et al. J Pain Res. .

Abstract

Purpose: Although chronic low back pain (CLBP) has profound effects on patients, society, and economy, its causes are difficult to identify. Psychogenic effects or social stress is known to affect CLBP; hence, investigation of its underlying causes requires a multifactorial approach. We determined the factors associated with CLBP by using an Internet-based survey. To prevent CLBP, we need to understand its cause and background.

Patients and methods: A total of 1000 participants either with (+) or without (-) CLBP answered the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), which assesses five domains of CLBP: low back pain, lumbar function, walking ability, social life function and mental health. We also administered a new questionnaire for participants, that comprised five different domains: Body, Lifestyle, Emotion, Diet, and Social. To evaluate psychogenic effects on CLBP, we added two original factors, namely outshout and HIE, which have not yet been studied. HIE is a traditional concept (sense) of "feeling cold" or "chilly." All participants completed both questionnaires.

Results: Multivariate logistic regression analysis extracted four factors (sleep, room temperature, outshout, and HIE) that were associated with CLBP. The mental health domain was assessed using the JOABPEQ for each of these factors. The factors outshout and HIE differed between CLBP (+) and CLBP (-) patients. CLBP (-) participants also showed a difference in Sleep and HIE factors.

Conclusion: Among psychogenic effects, Emotion was common to all the four extracted factors. There was no common physical divisor. Therefore, we hypothesized that acute low back pain might develop into CLBP in the presence of psychological stress or other emotional factors such as outshout or HIE. Hence, we need to consider both physical and psychogenic effects in the prevention and treatment of CLBP. Furthermore, appropriate evaluation and treatment of psychological stress may be effective in reducing CLBP.

Keywords: HIE; JOABPEQ; Japanese Orthopaedic Association Back Pain Evaluation Questionnaire; nonspecific low back pain; outshout.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Overview of CLBP (+) patients. The total number of CLBP (+) subjects was 286. Eighty-one of them consulted doctors, while 205 of them did not. Thirty-eight of them had specific CLBP, whose cause was organic, and the rest of them (248) had nonspecific CLBP, whose cause was not organic.
Figure 2
Figure 2
The scores of “mental health” on the four factors among CLBP (+) patients. We compared the score of OR = 1.000 (□) and that of OR > 1.000 (■) for each factor among CLBP (+) patients. ━, median; *P < 0.05. Abbreviations: CLBP, chronic low back pain; RT, room temperature.
Figure 3
Figure 3
A hypothesis for the development of nonspecific low back pain.
See this image and copyright information in PMC

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