The Impact of Comorbidities on Chronic Low Back Pain

Background: With an estimated treatment cost of $635 billion, low back pain is one of the costliest national public health challenges. The NIH Pain Consortium defines chronic low back pain (CLBP) as any back problem lasting longer than 3 months, with pain symptoms in more than half of the days during the past 6 months. Since 2016, the PRECISION Pain Research Registry has been collecting data from patients with CLBP in Texas. Purpose: This purpose of this study is to determine the impact of multiple comorbidities on psychological and physical components of pain in patients with CLBP. Methods: There were 519 patients in the study, including 264 (50.9%) with < 2 comorbidities (CLBP-S) and 255 (49.1%) patients with >3 comorbidities (CLBP-CM). The psychological characteristics of these two comorbidity groups were compared using the Pain Self-Efficacy Questionnaire (PSEQ) and the Pain Catastrophizing Scale (PCS). The physical characteristics of the groups were compared using a numerical rating scale for pain intensity (NRS) and the Roland-Morris Disability Questionnaire (RMDQ). Results: There was a statistically significant (p< 0.05) negative correlation between comorbidity scores and PSEQ scores, and there were significant positive correlations between comorbidity scores and PCS, NRS, and RMDQ scores. Discussion: These results provide evidence that patients with CLBP and a greater number of comorbidities experience more difficulty in psychologically coping with physical pain and disabilities than such patients with fewer comorbidities. These results suggest that psychological interventions, such as cognitive behavioral therapy, may benefit patients with CLBP and numerous comorbidities.