Which psychosocial factors are related to severe pain and functional limitation in patients with low back pain? br Psychosocial factors related to severe low back pain

Background: Low back pain (LBP) is a global public health issue. Psychosocial factors are linked to LBP. However, there is a lack of knowledge about the relation of psychosocial factors to clini-cal outcomes of patients with severe LBP. Objective: To investigate the relationship between specific psychosocial factors with severe pain and functional limitation of patients with LBP. Methods: A cross-sectional study of 472 participants with LBP was conducted. Participants com-pleted self-reported questionnaires, including psychosocial factors, characteristics of pain, and functional limitations. Two multivariable logistic regression models were performed with severe pain intensity (> 7 out of 10) and functional limitation (> 7 out of 10) (dependent variables) and 15 psychosocial factors (independent variables). Results: One hundred twenty-five (26.5%) participants had severe LBP. Patients with catastroph-ising symptoms were 2.21 [95%Confidence Interval (CI): 1.30, 3.77] times more likely to have severe pain and 2.72 (95%CI: 1.75, 4.23) times more likely to have severe functional limitation than patients without catastrophising symptoms. Patients with maladaptive beliefs about rest were 2.75 (95%CI: 1.37, 5.52) times more likely to present with severe pain and 1.72 (95%CI: 1.04, 2.83) times more likely to have severe functional limitation. Patients with kinesiophobia were 3.34 (95%CI: 1.36, 8.24) times more likely to present with severe pain, and patients with social isolation were 1.98 (95%CI: 1.25, 3.14) times more likely to have severe functional limitation.