Abstract
Background and purpose of study:
Chronic back pain is a complex and poorly understood condition incorporating sensory, cognitive and emotional elements. Research demonstrates a strong association between chronic back pain and cognitive and non-cognitive factors such as anxiety, depression, fear-avoidance and self-efficacy. However, until very recently, the way in which chronic back pain sufferers process their emotions was largely unknown. To this end, we conducted two case-control studies using a between-groups correlational design to investigate the relationship between chronic back pain and emotional processing.
Methods and results:
In study 1, 55 chronic back pain sufferers and 55 pain-free individuals were administered the Emotional Processing Scale (EPS) to determine whether chronic back pain sufferers process their emotions differently from pain-free individuals. In study 2, 32 CBP sufferers and 27 pain-free individuals were administered the EPS, PHQ-9 and the GAD-7 to further test if chronic back pain is associated with altered emotional process and whether anxiety and depression may play a role in this relationship.
Conclusion:
Our studies demonstrate that altered emotional processing and regulation are strongly associated with chronic back pain. Prospective studies are necessary before it can be ascertained whether this relationship is causative or as a consequence of chronic back pain. However, our results are in line with a recent prospective neuroimaging study, which demonstrates that chronification of low back pain shifts brain representation from nociceptive to emotional circuits. It is therefore critical that clinicians in the field of musculoskeletal care consider the role of emotional processing in their patients' evaluation and management.
