Depression, catastrophizing, and poor performance in women with persistent acute low back pain from vertebral compression fractures: A prospective study

Article type: Research Article

Authors: Kataoka, Hideki^{a; b; *} | Hirase, Tatsuya^{b; c} | Goto, Kyo^{a; b} | Honda, Ayana^a | Nakagawa, Koichi^{a; b} | Yamashita, Junichiro^a | Morita, Kaoru^d | Honda, Yuichiro^{b; c} | Sakamoto, Junya^{b; c} | Okita, Minoru^{b; c}

Affiliations: [a] Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan | [b] Department of Physical Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan | [c] Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan | [d] Department of Orthopedic Surgery, Nagasaki Memorial Hospital, Nagasaki, Japan

Correspondence: [*] Corresponding author: Hideki Kataoka, Department of Rehabilitation, Nagasaki Memorial Hospital, 1-11-54 Hukahori, Nagasaki-shi 851-0301, Japan. Tel.: +81 95 871 1515; Fax: +81 95 871 1510; E-mail: kataoka-hide@kii.bbiq.jp.

Abstract: BACKGROUND: Research on the multi-faceted characteristics of persistent severe acute lower back pain (LBP) resulting from acute vertebral compression fractures (VCFs) is lacking. OBJECTIVE: To investigate the psychological and functional status of older patients with persistent severe acute LBP after conservative treatment of VCFs. METHODS: This prospective study included women aged 50 years and older who had acute VCFs and were admitted to the hospital. Pain intensity, depression, pain catastrophizing, activities of daily living (ADL), muscle strength, and vertebral deformity were assessed on admission. At 2 and 4 weeks post-admission, physical performance tests were performed along with the above measures. RESULTS: We divided 131 participants into severe (n= 64) and mild (n= 67) groups according to their pain intensity at 4 weeks. Compared to the mild group, the severe group showed significantly higher levels of depression and catastrophizing, with significantly poorer muscle strength and endurance. There were no significant differences in ADL and vertebral deformities between the two groups. CONCLUSIONS: Our results suggest that older patients with persistent severe acute LBP resulting from VCFs tend to be depressed and pain catastrophizing. Furthermore, persistent severe acute LBP negatively impacts endurance and muscle strength but not ADL.

Keywords: Catastrophizing, depression, physical performance, severe lower back pain, VCFs

DOI: 10.3233/BMR-210220

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1125-1133, 2022