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. 2024 May 31;9(4):e1165.
doi: 10.1097/PR9.0000000000001165. eCollection 2024 Aug.

Trajectories of pain and depressive symptoms among people living with low back pain during the COVID-19 pandemic: a 24-month longitudinal study

Adriana Angarita-Fonseca  1   2 , Mathieu Roy  3   4 , Anaïs Lacasse  1 , Guillaume Léonard  5 , Pierre Rainville  6   7 , Marie-France Marin  8 , Iulia Tufa  9   10 , Erika L Gentile  3 , M Gabrielle Pagé  2   11
Affiliations

Trajectories of pain and depressive symptoms among people living with low back pain during the COVID-19 pandemic: a 24-month longitudinal study

Adriana Angarita-Fonseca et al. Pain Rep. .

Abstract

Introduction: We explored trajectories of pain intensity and depressive symptoms over the first 24 months of the pandemic in people with low back pain. Methods: This longitudinal study was conducted alongside the Quebec Low Back Pain Study. Starting in April 2020 and every 3 months until July 2022, 291 participants completed an online survey. Group-based trajectory modeling was used to identify patterns of pain intensity and depressive symptoms. Onset outbreak characteristics were then put in relation with trajectory groups using multivariate logistic regression. Results: The analysis revealed 5 trajectories of pain intensity and depressive symptoms, respectively. The pain trajectories were stable mild (n = 17, 5.8%); stable moderate (n = 103, 35.4%); stable severe (n = 81, 27.8%); U-shape (n = 24, 8.3%), and inverted U-shape (n = 66, 22.7%). The trajectories of depressive symptoms were stable none (n = 58, 19.9%); stable very mild (n = 61, 21.0%); stable mild (n = 85, 29.2%); stable moderate (n = 59, 21.7%); and severe slightly improving (n = 24, 8.3%). Pre-COVID everyday/nearly everyday pain, average pain intensity, and widespread bodily pain were predictive of pain trajectory groups. Higher pre-COVID depression, acute stress disorder, and lockdown measures-related stress were associated with moderate/severe depressive trajectories. Discussion: Our findings indicated relative stability of pain and depressive symptoms among participants during the COVID-19 pandemic but also highlighted subgroups of people who experienced temporary deterioration or improvement over the first months of the pandemic that then reverted back to baseline levels. Modifiable risk factors were identified before the onset of the pandemic, which could give preventive measures in targeted populations.

Keywords: COVID-19; Cortisol; Depression; Low back pain; Trajectories.

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Conflict of interest statement

M.G.P. received honoraria from Canopy Growth and research funds from Pfizer ULC Canada for work unrelated to this study. Coauthors do not have conflicts of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
Flowchart of the study.
Figure 2.
Figure 2.
Observed (OT) and predicted (PT) trajectories of pain intensity. IUS, inverted U-shape; S, stable severe; SM, stable moderate; SS, stable slight; US, U-shape.
Figure 3.
Figure 3.
Observed (OT) and predicted (PT) trajectories of depressive symptoms. S, severe slightly improving; SM, stable moderate; SML, stable mild; SN, stable none; SS, stable very mild.
Figure 4.
Figure 4.
Cortisol levels by trajectories of pain intensity. Median and 95% confidence interval.
Figure 5.
Figure 5.
Cortisol levels by trajectories of depression. Median and 95% confidence interval.
See this image and copyright information in PMC

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