Psychosocial and functional risk factors in the early stages of back pain:Effects on moderate pain

We investigated the association between psychological factors, physical fun ction, and moderate levels of spinal pain. Participants were 720 people sel ected from a general population survey with either No Pain (n = 449) or Mod erate Pain (n = 271). The Moderate Pain group reported an average intensity of 4.7 ton a 0 to 10 scale), no health care visits, and only 1 day of work absence during the past year. A questionnaire containing items about physi cal function, work, and psychological factors including abuse, fear-avoidan ce beliefs, anxiety, depression, distress, and catastrophizing was employed . A series of discriminant analyses showed that distress, perceived workloa d, physical function, sexual abuse, and catastrophizing were associated wit h moderate pain. The final solution correctly classified 77% of the partici pants. These findings underscore that psychological and functional factors are relevant, even for moderate pain problems and before health care or ins urance authorities have become involved. Because of the cross-sectional nat ure of the study more work is needed to understand the process by which per sistent pain and disability develop.