Somatic symptom burden may affect health-related quality of life in patients with chronic low back pain, according to a study published in PLoS One.

Japanese adults with chronic low back pain (n=3100) were recruited to participate in an internet survey to collect data on mental and physical health. A portion of the questionnaire was designed to determine the presence and duration of low back pain in participants.

In addition, somatic symptoms burden was assessed using the self-administered Somatic Symptom Scale-8 (SSS-8) questionnaire evaluating back pain; stomach or bowel issues; pain in the arms, joints, or legs; shortness of breath or chest pain; headaches, dizziness, sleeping difficulties; or low energy within the previous 7 days.

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Depressive symptoms and health-related quality of life were evaluated with the Patient Health Questionnaire-2 (PHQ-2) and the EuroQol 5 dimensions (EQ-5D on a scale of −0.11 to 1.00; 1.00 indicates perfect health) questionnaire.

The EQ-5D score (average, 0.78±0.18) was found to decrease with increasing PHQ-2 scores, indicating an inverse relationship between health-related quality of life and depressive symptoms. Greater depressive symptoms were associated with an increase in somatic symptom burden.

After adjusting for depression and baseline covariates, study participants with higher somatic symptom burden (scores ranging from 12 to 32) had lower health-related quality of life (regression coefficient, r=0.040 for high vs very high SSS-8 and r=0.218 for non to minimal vs very high SSS-8; Ptrend <.0001).

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Symptoms may have been misclassified as they were assessed with questionnaires. In addition, the findings may be restricted to the Japanese population.

“Somatic symptom burden might be an important factor for health-related quality of life in individuals with chronic low back pain, independent of depressive symptoms and the number of chronic conditions,” concluded the study authors.

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Fujii T, Oka H, Katsuhira J, et al. Association between somatic symptom burden and health-related quality of life in people with chronic low back pain. PLoS One. 2018;13(2):e0193208.