Psychological and physical factors related to disability in chronic low back pain

J Back Musculoskelet Rehabil. 2019;32(4):603-611. doi: 10.3233/BMR-181269.


Background: Chronic low back pain (CLBP) is a public health problem that causes high levels of disability. Psychological and physical factors could play a critical role in the disability perception of patients.

Objective: The objective was to identify the psychological and physical factors associated with CLBP disability in patients and assess differences between asymptomatic subjects and CLBP patients through physical tests and psychological self-reports.

Methods: A cross-sectional study was performed. Total sample of 80 participants were classified into two groups: patients with CLBP (n= 49) and asymptomatic subjects (i.e. the control group) (n= 31). The physical tests included lower back range of motion (LBROM), postural stability, lower back strength (LBS), and lumbopelvic motor control tests. The psychological self-reports included low back disability (Roland Morris Disability Questionnaire), self-efficacy, pain catastrophizing, and pain-related fear.

Results: Self-efficacy and LBS displayed moderate negative correlations with disability in patients with CLBP (R=-0.47 and -0.40, respectively). Disability was predicted by self-efficacy and LBROM (β=-0.45 and -033 respectively, p< 0.01), explaining 30% of the variance in these patients. The comparative analysis showed statistically significant differences between groups in the physical/psychological variables (p< 0.01); however, the effect-sizes were small for all these variables.

Conclusions: The results of this study highlight the relevance of psychological and physical factors in CLBP patient disability. Evaluation and treatment in CLBP patients should take these factors into account.

Keywords: Low back pain; chronic pain; disability; range of motion; self-efficacy.

MeSH terms

  • Adult
  • Catastrophization
  • Chronic Disease
  • Cross-Sectional Studies
  • Disability Evaluation
  • Disabled Persons / psychology*
  • Fear
  • Female
  • Humans
  • Low Back Pain / physiopathology
  • Low Back Pain / psychology*
  • Male
  • Middle Aged
  • Range of Motion, Articular
  • Self Report