Transition to chronic pain in men with low back pain: predictive relationships among pain intensity, disability, and depressive symptoms.
Pain intensity, disability, and depressive symptoms are hallmarks of chronic pain conditions, but little is known about the relationships among these symptoms in the transition from acute to chronic pain. In this study, an inception cohort of men with low back pain (N = 78) was assessed at 2, 6, and 12 months after pain onset. At 6 months, pain intensity, disability, and depressive symptoms were predicted only by their respective levels at 2 months after pain onset. At 12 months, pain intensity and depressive symptoms were predicted by heightened disability at 6 months after pain onset; 12-month depressive symptoms also were predicted by 2-month disability. Pain intensity was not predictive of changes in disability or depressive symptoms. These findings suggest that functional disability plays a more prominent role than pain intensity in the transition from acute to chronic pain. A "failure to adapt" conceptual model is presented to account for these results.
University of California, San Diego, School of Medicine, and Veterans Affairs San Diego Healthcare System, 92161, USA.
J E
JE
Epping-Jordan
D R
DR
Wahlgren
R A
RA
Williams
S D
SD
Pruitt
M A
MA
Slater
T L
TL
Patterson
I
I
Grant
J S
JS
Webster
J H
JH
Atkinson
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D004185:Disability Evaluation; D018450:Disease Progression; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors