THE IMPACT OF STRESSFUL LIFE EVENTS ON EXACERBATION OF CHRONIC LOW-BACK-PAIN

The impact of stressful life events on the development and onset of ch ronicity of low-back pain is not yet fully understood. Sixty-four cons ecutive patients with chronic low-back pain treated at the orthopedic out-patient unit of the Innsbruck University Hospital were investigate d with regard to stressful life events. Patients were classified into two groups: one group consisting of patients whose pain had an organic etiology (n=16), and another group consisting of those with pain of u ncertain origin (idiopathic group, n=48). A method combining a semistr uctured interview with a self-assessment of the severity of stress cau sed by life events was employed for assessing the impact of such event s on chronic low-back pain. In comparison to the patient group having organic causes of pain, the idiopathic group showed significantly more patients having at least one highly stressful event preceding the las t substantial aggravation of pain (p=0.028). The latter group experien ced significantly more exhaustion (p=0.016) and significantly more dif ficulties in active coping (p=0.011) when confronted with stressful li fe events. Stressful life events that arouse feelings of helplessness may contribute to the development of chronic idiopathic low-back pain. Our results emphasize the importance of investigating the subjective meaning and appraisal of stressful life events, taking into considerat ion both individual predisposition and psychosocial resources availabl e to the patient. Finally, it is also important that the attending phy sician be aware of any life event that is particularly stressful for t he patient so that psychosocial help be made available at the appropri ate time. (C) 1998 Elsevier Science Inc.