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Relationship between low back pain and life-stressing events among Nigerian and Caucasian patients

2007; Elsevier BV; Volume: 94; Issue: 2 Linguagem: Inglês

10.1016/j.physio.2007.08.009

1873-1465

Michael O. Egwu, Vincent C. B. Nwuga,

Workplace Health and Well-being

Objectives Socio-economic status and life-stressing events have been shown to have ethnic and racial differences that exert a strong influence on care-seeking habits and recovery from low back pain (LBP). This study examined the relationship between life-stressing events and sensory and psychological attributes among Nigerian and Caucasian patients with LBP, and the influence of socio-economic status on this relationship. Design Stratified, single cohort questionnaire study. Setting Three outpatient physiotherapy clinics in Nigeria. Participants One hundred and sixty-five patients, including 107 Black Nigerians (age range 26–65 years, mean 52 years) and 58 Caucasians (age range 25–62 years, mean 41 years), with LBP of at least 6 weeks duration were recruited over a 9-year period. Main outcome measures The Low Back Pain Questionnaire, Social Re-adjustment Rating Scale, State-Trait Anxiety Inventory and Multiple Affect Adjective Check List. Socio-economic status and pain levels, on a 0–100 numerical rating scale, were also recorded. Questionnaires were administered within 5 days of the patient reporting at the clinic. Results Recorded pain intensity was similar in Nigerian [mean pain score 78, 95% confidence interval (CI) 73.4 to 83.4] and Caucasian (mean pain score 79, 95% CI 74.8 to 84.8) patients. Subjects who recorded higher numbers of life-stressing events on the Social Re-adjustment Rating Scale also recorded higher scores on a number of LBP attributes including hot, burning, bright, throbbing and pressure qualities. Pain intensity and state anxiety correlated significantly with life-stressing event scores among Caucasian patients, who were mainly of high socio-economic status. State and trait anxiety and emotional discomfort scores correlated significantly with life-stressing event scores among Nigerian patients, who were mainly of low to medium socio-economic status. Conclusion Most patients had experienced a number of life-stressing events, particularly those classified as being of low socio-economic status. Low socio-economic status patients who had experienced a high number of life-stressing events were more likely to show emotional and psychological symptoms, which may have influenced the reporting of the characteristics and history of their LBP. There is a need to assess these issues when managing LBP patients. Further research is required to determine how the outcome of treatment may be influenced by these factors.