The relationship between chronic low back pain and fatigue: a systematic review

Background: Fatigue is a common non-specific symptom in the general population. The association between fatigue and pain is high and people with chronic conditions and/or pain report high prevalence of fatigue. Individuals with chronic low back pain (CLBP) often experience fatigue symptoms and those who experience fatigue are more likely to have restricted physical functioning. It is important to clarify the association between CLBP and fatigue in order to devise management strategies which alleviate and/or manage fatigue symptoms while improving physical functioning in individuals with CLBP. Objectives: The main aim of this systematic review is to determine the level of evidence supporting the association between self-reports of LBP and fatigue in individuals with CLBP. Methods: Major electronic databases were searched since inception till April 2016. Studies comparing the association between CLBP and general fatigue were included. Results: Considerable heterogeneity in the included studies precluded a meta-analysis. Five studies were included for final descriptive synthesis. There is very limited evidence to support the association between presence of CLBP and fatigue. There is moderate evidence to support the association between CLBP intensity and/or CLBP functional disability and fatigue. Conclusion: The association between fatigue and CLBP is under researched although there is moderate association between CLBP intensity and CLBP disability with fatigue. Fatigue is an important symptom that should be considered in the assessment and management of patients with CLBP.