Impaired Social Functioning Impacts Pain Levels, Catastrophizing in Chronic Low Back Pain

Impaired social functioning contributes to increased pain catastrophizing and higher pain levels among patients with chronic low back pain (cLBP), according study results published in Pain Medicine.

Investigators assessed pain levels, social functioning, and pain catastrophizing among patients with cLBP vs pain free individuals (control group), further analyzing how pain catastrophizing may explain between-group differences in social functioning.

Researchers conducted an observational study including 62 adults with self-reported cLBP and 79 members of a control group, who completed validated, self-reported measures of pain, social functioning, and pain catastrophizing.

A mediation analysis was used to investigate whether catastrophizing mediated the group differences (cLBP vs controls) regarding social functioning. An exploratory follow-up mediation analysis examined whether social functioning mediated the link between catastrophizing and pain among the cLBP subgroup participants.

Patients with cLBP experienced more intense pain (P <.001), impaired social functioning (P <.001), and higher levels of catastrophizing (P =.004) compared with the control group.

Higher levels of pain catastrophizing were associated with more intense pain (P <.001) and impaired social functioning (P <.001).

More intense pain was also associated with impaired social functioning (P <.001)

According to mediation analysis, differences between the cLBP and control groups in impaired social functioning were significant, accounting for 28% of total variance. Pain catastrophizing contributed to an additional 9% of variance when added to the final model.  

The negative impact of pain catastrophizing on social functioning partially mediated the group differences observed between cLBP participants and members of the pain-free control group.

Social functioning was found to mediate the relationship between higher levels of catastrophizing and greater pain experienced by participants with cLBP.

Among several study limitations, most participants were White and women, which may limit the generalizability of the findings. Additionally, employment status and medical comorbidities were not assessed in the study.

The study authors concluded, “Interventions, such as cognitive behavioral therapy, should address catastrophizing in individuals with cLBP, while simultaneously improving social functioning.”