Pain acceptance and illness intrusiveness in low-back pain: A longitudinal study.

Background: In chronic pain syndromes, acceptance of pain may be a better approach than pain control. So far, little data have been available on how pain and its acceptance affect illness intrusiveness among patients with low-back pain (LBP).

Objective: The present longitudinal study evaluates the impact of pain acceptance on illness intrusiveness in patients with LBP.

Methods: Study participants were asked to complete the following questionnaires during their visit (T1) at one of four diverse rheumatologic outpatient clinics, and then 2-3 months later (T2) phone or online: Chronic Pain Acceptance Questionnaire (CPAQ), Illness Intrusiveness Rating Scale (IIRS), Roland-Morris Disability Questionnaire (RMDQ), Patient Health Questionnaire Depression subscale (PHQ9), and socioeconomic data.

Results: One hundred and twenty-seven individuals completed the questionnaires at baseline (31 having acute, 15 subacute and 81 chronic low back pain) and 97 at follow-up. Illness intrusiveness was negatively correlated with chronic pain acceptance both at T1 (r = -0.39) and T2 ( = -0.44). Illness intrusiveness scores have not changed significantly from T1 ( = 28.59 SD = 13.08) to T2 ( = 28.24, SD = 15.76). In a multiple regression model-including pain intensity, functional status, pain acceptance, depression severity, age, sex and educational level-the independent predictors of follow-up illness intrusiveness scores were lower pain acceptance and higher depression scores.

Conclusions: In our study, patients with acute, subacute and chronic low back pain reported similar levels of illness intrusiveness. In addition, illness intrusiveness scores have not changed significantly during the 2-month follow-up period and pain acceptance proved to be a significant independent predictor of illness intrusiveness among patients with chronic low-back pain.