Back pain eased by a little adversity

U. BUFFALO (US)—A little adversity may actually be beneficial and protective to those with chronic back pain, a new study finds.

These individuals experience less physical impairment and spend less time in doctor’s offices or health clinics, says Mark Seery, assistant professor of psychology at the University at Buffalo.

Seery emphasizes that the key to the benefit is the experience of “some” prior adverse events as opposed to many or none at all.

“This study of 396 adults with chronic back pain (CBP) found that those with some lifetime adversity reported less physical impairment, disability, and heavy utilization of health care than those who had experienced either no adversity or a high level of adversity,” Seery says.

“The data suggest that adversity-exposure also may protect against psychiatric disturbances that occur with CBP,” Seery says, “and additional analyses found no alternative explanations of our findings.”

Details will appear in the September issue of the journal Pain.

Study participants had previously acknowledged a history of CBP when reporting physical health status in an online survey. They completed a survey of lifetime exposure to 37 adverse events, including one’s own or a loved one’s illness/injury, sexual and non-sexual violence, bereavement, social or environmental stress, disaster, and various relationship stresses.

Subjects subsequently reported self-rated functional impairment, disabled employment status, frequency of back pain treatment, prescription painkiller use, and whether they currently sought treatment for comorbid psychiatric disorders.

Observed patterns of relationships between adversity and CBP-related outcomes may reflect the possibility that resilience, a phenomenon largely ignored in previous CBP research, is occurring.

“It appears,” says Seery, “that adversity may promote the development of psychological and social resources that help one tolerate adversity, which in this case leads to better CBP-related outcomes.

“It may be that the experience of prior, low-levels of adversity may cause sufferers to reappraise stressful and potentially debilitating symptoms of CBP as minor annoyances that do not substantially interfere with life.”

Previous attempts to understand the persistence, refractoriness, and disability associated with CBP have underscored the importance of psychosocial variables and demonstrated an association between CBP and lifetime exposure to adverse events.

“Previous research suggests that exposure to adverse life events correlates with greater CBP severity,” he says. “This implies that the optimal situation would be one in which individuals have not been exposed to any adverse lifetime events.

“It appears, however, that the relationship between adversity and chronic pain is not so simple, in that experiencing some prior adversity is actually most beneficial.”

Researchers from the University of California, Irvine contributed to the study.

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