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Lower Spine News

Chronic Low Back Pain, Psychosocial Distress, and Disability

Studies show that psychosocial distress is linked with chronic low back pain (CLBP). People who are depressed, anxious, or stressed are at greater risk for CLBP. Fear, uncertainty, anger, and hostility are other ways distress is expressed.

Researchers are trying to find ways to measure psychosocial distress. They want to be able to predict disability among patients with CLBP. There are many tools already available for assessing distress. Each one seems to measure different aspects of distress. There isn't one all-purpose instrument to measure distress in this group of patients.

In this study, the Symptom Checklist-90 (SCL-90) and the Roland Morris Disability (RMDQ) are given to CLBP patients before treatment. The SCL-90 is a self-report inventory of psychosocial distress. Eight categories of psychosocial distress are examined.

The RMDQ measures self-reported disability caused by LBP. Physical functions such as walking, bending, sitting, lying down, and sleep are included. Physical activities and self-care are also reported.

The goal was to measure the strength of the relationship between distress and disability using these two tools. Is it necessary to use both questionnaires? Is one a better measure of disability than the other?

The results show that when using these two tools, a weak relationship between psychosocial distress and disability was seen in patients with CLBP. Other studies using the same two tests but doing so separately show a stronger relationship. It's unclear why this difference occurred. Perhaps it's because this study combined the use of SCL-90 and RMDQ.

The authors suggest further studies using other combinations of instruments are needed. Finding the best group of tools to identify the impact of psychosocial distress on self-reported disability is needed. Accurate assessment tools can help reduce disability and guide treatment for patients with CLBP.


Henrica R. Schiphorst Preuper, et al. The Relationship Between Psychosocial Distress and Disability Assessed by the Symptom Checklist-90-Revised and Roland Morris Disability Questionnaire in Patients with Chronic Low Back Pain. In The Spine Journal. November 2007. Vol. 7. No. 5. Pp. 525-530.


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