Association of constipation-related characteristics with low back pain severity in patients with lumbar disc herniation and chronic constipation: a cross-sectional study

Background Lumbar disc herniation (LDH) significantly impairs quality of life. Although chronic constipation is also observed in some patients with LDH, the associations between constipation-related characteristics and low back pain severity in this specific subgroup remain insufficiently characterized. This study aimed to quantify, among patients with LDH and chronic constipation, the associations between constipation-related characteristics, lifestyle factors, analgesic use, and low back pain severity. Methods This hospital-based cross-sectional study included 200 patients with lumbar disc herniation (LDH) and chronic constipation. Variables included demographic data; constipation-related variables (Wexner Constipation Score, Bristol Stool Form Scale score, and duration of constipation); pain and disability indices (visual analogue scale [VAS] and Oswestry Disability Index [ODI]); analgesic use; and lifestyle factors (dietary fiber intake, daily water consumption, and physical activity time). Between-group comparisons, Pearson correlation analyses, and multiple linear regression analyses were performed using the complete study dataset. Results Among the 200 patients, the mean VAS score was 6.24 ± 2.28, the mean Wexner score was 14.07 ± 5.64, and the mean ODI was 40.31 ± 9.73%. Wexner score was strongly correlated with VAS ( r = 0.861, P < 0.001). In multivariable regression, Wexner score (B = 0.290, P < 0.001), Bristol stool score (B = -0.208, P < 0.001), dietary fiber intake (B = -0.045, P = 0.011), and daily water intake (B = -0.0018, P < 0.001) remained independently associated with VAS. The model R² was 0.799. Conclusions Greater constipation symptom burden and selected bowel-related lifestyle characteristics were statistically associated with greater low back pain severity in patients with LDH and chronic constipation. These findings support further longitudinal and interventional studies to clarify temporal and causal relationships. Clinical trial registration Not applicable. This was a crosssectional observational study and participants were not assigned to a healthrelated intervention.