Social Support is Inversely Associated with Sleep Disturbance, Inflammation, and Pain Severity in Chronic Low Back Pain

Abstract Objective For most patients with chronic low back pain (cLBP), the cause is “nonspecific,” meaning there is no clear association between pain and identifiable pathology of the spine or associated tissues. Laypersons and providers alike are less inclined to help, feel less sympathy, dislike patients more, suspect deception, and attribute lower pain severity to patients whose pain does not have an objective basis in tissue pathology. Because of these stigmatizing responses from others, patients with cLBP may feel that their pain is particularly unjust and unfair. These pain-related injustice perceptions may subsequently contribute to greater cLBP severity. The purpose of this study was to examine whether perceived injustice helps explain the relationship between chronic pain stigma and movement-evoked pain severity among individuals with cLBP. Methods Participants included 105 patients with cLBP who completed questionnaires assessing chronic pain stigma and pain-related injustice perception, as well as a short physical performance battery for the assessment of movement-evoked pain and physical function. Results Findings revealed that perceived injustice significantly mediated the association between chronic pain stigma and cLBP severity (indirect effect = 6.64, 95% confidence interval [CI] = 2.041 to 14.913) and physical function (indirect effect = −0.401, 95% CI = −1.029 to −0.052). Greater chronic pain stigma was associated with greater perceived injustice (P = 0.001), which in turn was associated with greater movement-evoked pain severity (P = 0.003). Conclusions These results suggest that perceived injustice may be a means through which chronic pain stigma impacts nonspecific cLBP severity and physical function.

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Various types of sleep disturbance due to different sorts of low-back pain: A literature review: 3. Back pain severity, symptoms, signs, and sorts of sub-diagnosis

International Musculoskeletal Medicine ◽

10.1179/1753614615z.000000000104 ◽

2015 ◽

Vol 37 (3) ◽

pp. 115-124 ◽

Cited By ~ 1

Author(s):

Brian J. Sweetman

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Literature Review ◽

Sleep Disturbance ◽

Pain Severity ◽

Low Back

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Reverse transformation of Modic Type 2 changes to Modic Type 1 changes during sustained chronic low-back pain severity

Journal of Neurosurgery Spine ◽

10.3171/spi.2007.6.2.152 ◽

2007 ◽

Vol 6 (2) ◽

pp. 152-155 ◽

Cited By ~ 28

Author(s):

Laurence A. G. Marshman ◽

Matthew Trewhella ◽

Tai Friesem ◽

Chandra K. Bhatia ◽

Manoj Krishna

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Reverse Transformation ◽

Pain Severity ◽

Low Back ◽

Modic Type ◽

Generating Capacity

✓Modic Type 2 (MT2) neuroimaging changes are considered stable or invariant over time and relatively quiescent, whereas Modic Type 1 (MT1) changes are considered unstable and more symptomatic. The authors report two cases in which MT2 changes were symptomatic and evidently unstable, and in which chronic low-back pain severity remained unaltered despite a MT2–MT1 reverse transformation. Two women (41 and 48 years old) both presented with chronic low-back pain. Magnetic resonance (MR) images demonstrated degenerating discs at L5–S1 associated with well-established MT2 changes in adjacent vertebrae. Repeated MR imaging in these two patients after 11 months and 7 years, respectively, revealed reverse transformation of the MT2 changes into more florid MT1 changes, despite unaltered chronic low-back pain severity. Following anterior discectomy and disc arthroplasty, immediate abolition of chronic low-back pain was achieved in both patients and sustained at 3-year follow up. Modic Type 2 changes are therefore neither as stable nor as quiescent as originally believed. Each type can change, with equal symptom-generating capacity. More representative imaging–pathological correlates are required to determine the precise nature of MT changes.

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Burden of Chronic Low Back Pain: Association With Pain Severity and Prescription Medication Use in Five Large European Countries

Pain Practice ◽

10.1111/papr.13093 ◽

2021 ◽

Author(s):

Serge Perrot ◽

Michael J Doane ◽

Dena H Jaffe ◽

Erika Dragon ◽

Lucy Abraham ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Medication Use ◽

Prescription Medication ◽

European Countries ◽

Pain Severity ◽

Low Back

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Cognitive behavioural therapy and core stabilization exercise on pain-related disability and psychological status in patients with non-specific chronic low back pain

European Journal of Clinical and Experimental Medicine ◽

10.15584/ejcem.2020.3.6 ◽

2020 ◽

Vol 18 (3) ◽

pp. 188-194

Author(s):

Ashiyat Kehinde Akodu ◽

◽

Thompson Adewale Ogunbiyi ◽

Oluwaseun Akinleye Fapojuwo ◽

◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Sleep Disturbance ◽

Cognitive Behavioural Therapy ◽

Chronic Low Back Pain ◽

Behavioural Therapy ◽

Psychological Status ◽

Low Back ◽

Core Stabilization ◽

Cognitive Behavioural

Introduction. Exercises have been shown to relieve symptoms in non-specific chronic low back pain (NSCLBP) patients. Aim. This study compared the effects of cognitive behavioural therapy (CBT) and core stabilization exercises (CSE) on pain-related disability, psychological status and sleep disturbance in patients with NSCLBP. Material and methods. This randomized controlled trial involved a total of thirty-seven (37) participants. They were randomly allotted into three groups [CBT (11), CSE (14) and control (12)]. The intervention was done once per week for duration of 60 minutes for the CBT group, 30 minutes for CSE group and 10 minutes for the control group twice per week for 8 consecutive weeks. Assessment of outcome was done at baseline, 4 weeks and 8 weeks. Data were analyzed using statistical package for social science version 25 at alpha level of less than 0.05. Results. The results of this study showed that there was significant improvement in the level of pain-related disability (p= 0.001), level of anxiety (p =0.001), depression (p = 0.01, p = 0.001, p =0.001) and sleep disturbance (p = 0.001) in all the groups (CBT, CSE, control) post treatment. Conclusion. CBT and CSE are both effective in the treatment of pain-related disability, sleep disturbance, and psychological status of NSCLBP patients.

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