title: The relationship between pain, disability, quality of life and cognitive-behavioural factors in chronic back pain.
abstract: OBJECTIVE
  This pilot study systematically examined the correlations between the outcome variables pain intensity, disability and health-related quality of life (HRQOL) and between these outcomes and known psychological risk factors for chronic low back pain (CLBP), such as depression, trait anxiety, avoidance- and endurance-related pain responses at two different assessment points.
  
  
  METHODS
  Data from 52 CLBP inpatients treated in an orthopedic clinic were investigated at two points in time: during the first days after admission and 6 months after the termination of the inpatient treatment. Bivariate relationships between pain intensity, disability, HRQOL and psychological variables were examined with the help of Pearson product moment correlations. Furthermore, the differences that exist between correlations at baseline and follow-up were tested for significance.
  
  
  RESULTS
  Significant and large differences were found between the correlations with low correlations at baseline and high correlations at the follow-up. Furthermore, HRQOL showed a positive correlation with endurance-related and a negative correlation with avoidance-related pain responses.
  
  
  CONCLUSIONS
  Focusing on a systematic comparison of two significant assessment time points in CLBP with an acute exacerbation at baseline, the results of this study underlined the recurrent course of LBP. The results highlight that the assessment time points play an important role in CLBP.
  
  
  CONCLUSIONS
  • Low back pain is a major public health problem with high direct and indirect back-pain-related costs. • Chronic low back pain is a disabling disease which restricts quality of life. • Psychological factors may have a larger impact on disability and quality of life than pain itself. • The recurrent course of low back pain highlights the importance of multidisciplinary pain management even during acute exacerbations of pain.
authors.affiliation: Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany. Sarah.Scholich@rub.de
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Scholich
authors.forename: Dirk
authors.initials: D
authors.lastname: Hallner
authors.forename: Ralf H
authors.initials: RH
authors.lastname: Wittenberg
authors.forename: Monika I
authors.initials: MI
authors.lastname: Hasenbring
authors.forename: Adina C
authors.initials: AC
authors.lastname: Rusu
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003071:Cognition; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D017116:Low Back Pain / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult