The effect of psychosocial factors in the success of conservative management for low backache

<p>Noor ul Huda Maria, Qurrat ul Ain Siddiq and Muhammad Anwar Chaudry</p>

The effect of psychosocial factors in the success of conservative management for low backache

Noor ul Huda Maria, Qurrat ul Ain Siddiq and Muhammad Anwar Chaudry

Pakistan

: J Spine Neurosurg

Abstract

Aim: The aim is to study the impact of psychosocial factors in the success of conservative treatment for low backache.

Method: Randomized controlled trials conducted at Lahore General Hospital, Pakistan. 150 patients with low backache were enrolled. Visual Analog Scales (VAS) for low back, coping strategies questionnaire, fear-avoidance beliefs questionnaire and a questionnaire to inquire about the psychosocial environment of the patient that included the evaluation of education, family members living with the patient or away and their level of communication and relationships, social status, job satisfaction, environment, acute/chronic depression, anxiety, bullying, financial status, personality and view regarding surroundings. Follow up was done for 12 months. Patients failing conservative treatment were assed.

Result: In subjects with LBP, FAB correlated moderately with catastrophizing (r=0.388) and disability (r=0.398) and weakly with LP (0.139) not with LBP. In the successful with conservative treatment group 85% were satisfied with job, environment and financially, 80% well educated, 75% living with families, 70% calm personality, 67% had good social networking and 65% no major stress factor. Out of 55 patients who failed 20% had disc issues necessitating surgery on clinical and radiological basis, 80% were anxious and apprehensive. 45% were females with apprehensions, 47% living alone, 53% were living in stressful environment, 65% unskilled, unemployed and dependent and 75% had no emotional support, out of the 35% employed, 85% were not satisfied with job.

Conclusion: From this study we conclude that psychosocial environment plays a very important role in the management of low backache using conservative measures. Low back pain is known to have a psychosomatic component. Increased bodily awareness referred to as somatization and depressive symptoms are two very important factors that may affect the outcome. Health personnel should always address the psychosocial factor in a given patient with low backache as an important factor for treatment outcome.