Differences between chronic low back pain patients in Germany and Thailand in terms of nature of disease and socioeconomic and psychological factors

Abstract

BACKGROUND: Worldwide, chronic low back pain (CLBP) is one of the most common causes of physical and psychological disabilities. The factors that affect low back pain (LBP) between Western and Eastern countries are different. OBJECTIVE: We assessed the factors associated with LBP and their impact in German and Thai CLBP participants. METHODS: This cross-sectional study was conducted in 100 Thai and 100 German CLBP participants. Data were collected before the participants received treatment in the outpatient rehabilitation clinic. We used standardized questionnaires to assess the demographic and socioeconomic data, clinical features of the pain, the impact of pain during daily activities, and psychological consequences. RESULTS: We found a statistically significant difference between the two groups for minimal pain intensity (NRS German = 3.01, Thai = 1.83), and the participants’ acceptable pain intensity (NRS German = 1.97, Thai = 3.88). The German participants had a higher negative impact score in their daily living compared to the Thai participants (German = 23.5, Thai = 10). Also, the German participants suffered more often from depression (CES-D score; German = 17, Thai = 4). However, the average back pain intensity was the same for both groups. CONCLUSION: German CLBP participants had significantly more depressive symptoms and pain-related impairments compared to the Thai participants. On the other hand, there were no differences in maximum and average pain severities.

Which outcome variables are associated with psychological inflexibility/flexibility for chronic pain patients? A three level meta-analysis

“…This study found that the type of country was a moderating variable in the relationship between psychological inflexibility and pain intensity or depression, significantly higher in chronic pain patients in western countries than in eastern countries. It is consistent with previous cross-sectional studies, which suggest that patients in Eastern countries may have a greater tolerance for pain (Thong et al, 2017 ; Yotnuengnit et al, 2022 ). This may be related to underlying cultural differences: stoicism is seen as a positive quality in Eastern cultures, whereas the inability to tolerate pain is seen as a sign of weakness (Narayan, 2010 ; Thong et al, 2017 ).…”