Pain Catastrophizing Is Related to Static Postural Control Impairment in Patients with Nonspecific Chronic Low Back Pain: A Cross-Sectional Study

Abstract

Purpose. Pain catastrophizing may contribute to the altered trunk muscle activity in patients with nonspecific chronic low back pain (NSCLBP). It is unclear if pain catastrophizing influences static postural control in patients with NSCLBP. This study aimed to investigate the relationship between pain catastrophizing and static postural control in NSCLBP patients. Methods. Sixty-eight participants with NSCLBP and 40 healthy participants were recruited. Postural control was assessed by the sway area and the sway length of the center of pressure (COP) during balance tests. Pain catastrophizing in participants with NSCLBP was assessed by the Pain Catastrophizing Scale (PCS). Bilateral transversus abdominis (TrA) activation was evaluated by ultrasound imaging-measured percent change in muscle thickness. Associations between COP parameter and PCS/subscales of PCS were examined by multiple linear regression (MLR). Results. Our results observed a larger COP sway area in NSCLBP group under eyes-closed condition p < 0.001 and a lower level of voluntary activation of the bilateral TrA p < 0.001 , compared with the healthy control group. The MLR analyses revealed that the COP area sway under eyes-closed condition was significantly associated with the PCS score/helplessness score of PCS, voluntary activation of the left TrA, and age in participants with NSCLBP (β = 0.222/0.236, 0.341/0.344, and 0.328/0.325; p = 0.045 / 0.033 , 0.002, and 0.004, resp.). Conclusions. Static postural control was associated with pain catastrophizing, voluntary activation of TrA, and age in participants with NSCLBP. This indicated that pain catastrophizing may affect postural control and should be considered when interpreting balance test results and managing NSCLBP.

Difference in postural stability between STarT Back Tool subgroups of patients with low back pain under conditions of sensory deprivation and cognitive load

“…The reason we found no between-group differences could be owing to the stratification of participants. The distress subscale of the SBT 37 includes items associated with decreased postural stability, including pain catastrophizing, 26 depression, 27 and fear. 28 , 29 The SBT may not being sufficiently sensitive to identify the domains within these psychological states that pertain to decreased postural stability.…”

Can Numerical Pain Rating Scale and Pain Catastrophic Scale Predict Lumbar Radiculopathy?

“…Therefore, it is of great importance that patients are educated and informed both before and after the operation. In addition, it has been reported that pain catastrophizing can affect postural control and should be taken into account in interpreting balance test results when managing chronic low back pain [25] . Clinicians should also screen patients with lumbar discopathy for catastrophic and destructive thinking and manage the treatment process with support from other disciplines such as psychiatry when available.…”

The Association of Fear of Movement and Postural Sway in People with Low Back Pain

“…These aspects may have played a role causing the differences between the observed results. Other researchers who assessed the association of fear variables and postural sway under bipedal stance conditions without platform perturbations obtained deviating results (Mazaheri et al, 2014;Kahraman et al, 2018;Zhang et al, 2020;Mikkonen et al, 2022). Mazaheri et al (2014) concluded that fear did have little effect but did not report the association of sway and fear directly.…”

“…Instead, the inference was made by comparison of a group of people who had just overcome LBP (as fear was not diminished in this group yet), to people with ongoing and without LBP (Mazaheri et al, 2014). In addition, other studies have reported data on the influence of fear on postural sway or other balance measures in people with LBP (Sung et al, 2015;Jacobs et al, 2016;Kahraman et al, 2018;Shanbehzadeh et al, 2018;Hlaing et al, 2020;Zhang et al, 2020;Mikkonen et al, 2022). Shanbehzadeh et al (2018) found that participants with greater fear showed decreased postural sway across multiple conditions including manipulations of vision, proprioception, and cognition.…”