title: Patients' perceived level of social isolation affects the prognosis of low back pain.
abstract: BACKGROUND
  Perceived social isolation is prevalent among patients with low back pain (LBP) and could be a potential prognostic factor for clinical outcomes following an episode of LBP.
  
  
  METHODS
  A secondary analysis of an original prospective cohort study, which investigated the validity of the Danish version of the STarT Back Screening Tool (STarT), investigated whether social isolation predicts the clinical outcomes of disability, anxiety, depression and pain catastrophizing in people with LBP. Patients with LBP of any duration (N = 204) from Middelfart, Denmark, were included. Social isolation was measured at baseline using the friendship scale (score ranges from 0 to 24, with lower values meaning higher perceived social isolation), and outcomes were measured at baseline and at 6-month follow-up. Regression models investigated whether social isolation at baseline predicted the outcomes at 6-month follow-up.
  
  
  RESULTS
  Some level of social isolation was reported by 39.2% of the participants (n = 80) with 5.9% (n = 12) being very socially isolated. One-point difference on social isolation predicted one point on a 100-point disability scale (adjusted unstandardized coefficient: -0.91; 95% confidence interval (CI): -1.56 to -0.26). Social isolation predicted anxiety; however, a change of one point on the social isolation scale represents a difference of only 0.08 points on a 22-point scale in anxiety (95% CI: 0.01-0.15) and is unlikely to denote clinical importance. Social isolation did not predict pain catastrophizing or depression.
  
  
  CONCLUSIONS
  Patients' perceived social isolation predicts disability related to LBP. Further understanding of the role of social isolation in LBP is warranted.
authors.affiliation: Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: V C
authors.initials: VC
authors.lastname: Oliveira
authors.forename: M L
authors.initials: ML
authors.lastname: Ferreira
authors.forename: L
authors.initials: L
authors.lastname: Morso
authors.forename: H B
authors.initials: HB
authors.lastname: Albert
authors.forename: K M
authors.initials: KM
authors.lastname: Refshauge
authors.forename: P H
authors.initials: PH
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010465:Perception / Q000502:physiology; D011379:Prognosis; D011446:Prospective Studies; D012934:Social Isolation; D011795:Surveys and Questionnaires