Chronic lower back pain linked to stress

Chronic lower back pain (LBP) is directly associated with degree of stress, a recent Korea study has found.

Drawing from the 2013, 2014, and 2015 cycles of the Korean National Health and Nutrition Examination Survey (KNHANES), researchers enrolled 8,437 participants, of whom 357 had chronic LBP; the rest were set as controls. Stress was assessed through the following question in KNHANES: “How much stress do you usually feel in your daily life?”

Multivariate regression analysis adjusted for age and sex found a significant link between mild stress and chronic LBP (odds ratio [OR], 1.57; p<0.001), which increased in magnitude when looking at moderate (OR, 2.74; p<0.001) and severe (OR, 3.26; p<0.001) stress.

The significant and increasing correlation remained after additional model adjustments for environmental factors such as obesity, sleep duration, smoking and alcohol consumption, occupation, physical activity, income, education level, and comorbidities.

Severe stress was most strongly associated with chronic LBP (OR, 2.82; p<0.001) when compared with moderate (OR, 2.54; p<0.001) and mild (OR, 1.55; p<0.001) stress, though the latter two remained significant correlates. Stratifying by sex further revealed that the link between chronic LBP and all levels of stress was stronger in men.

“It is necessary to recognize that degree of stress and chronic LBP are related, and clinicians should evaluate the degree of stress when treating patients with chronic LBP,” the researchers said.