Ab0156 Psychological Impact of Low Back Pain on General Population: A Tunisian Survey

Background: Low back pain (LBP) is a common global health issue. It is one of the most frequent causes of disability worldwide. Numerous psychological conditions may interact with LBP and be predictive of chronicity and disability in these patients. Objectives: The aim of this study was to evaluate the psychological impact of LBP on general population. Methods: We conducted a cross-sectional electronic study consisting of an online questionnaire made via the google-forms platform. This questionnaire, in Arabic and French, consisted of 53 questions regarding socio-demographic data, clinical aspects, and working conditions. We evaluated the LBP via the Nordic Musculoskeletal health questionnaire 1 and its impact via the Oswestry Disability Index (ODI) 2 and the Short Form 36-item Health Survey (SF36) 3. Results: There were 344 participants in this survey. The mean age was 34.98±8.53 years. The sex ratio (women/men) was 3.52. The mean body mass index (BMI) was 24.52±4.88 kg/m2. A BMI≥25 kg/m2 was noted in 42.8% of cases. A family history of LBP was found in 29% of cases. Most participants were employed (55.8%) or students (31.4%), office work was reported in a third of cases. Regular physical activity was noted in 26.5% of responses. Daily sleep time was 4 to 8 hours in 78.5% of cases, less than 4 hours in 3.5% and more than 8 hours in 18%. According to the Nordic questionnaire, the point, annual and lifetime prevalence of LBP were 68.9%, 81.7%, and 95.6%, respectively. The mean ODI was 9.43±6.40. A moderate and severe disability was reported on 15.4% and 2.7% of cases, respectively. The mean LBP level assessed by the visual analogue scale (VAS) was 5.24±2.96. At least 86.9% of participants reported a psychological complaint. Concerning the psychosocial and emotional items of the SF36, over the past 4 weeks and due to feelings of anxiety and depression related to LBP, 58.7% of respondent had reduced the time spent on work or other activities, 50% had done less than they expected and 51.7% had not done their work or other activities with as much attention as usual. As for social activities, emotional problems related to LBP had interfered with social activities in 76.2% of cases with a significant disturbance in 36.9% of them. In addition, regarding energy and emotions items, 78.2% felt full of enthusiasm, 75.3% nervous, 57.2% so depressed that nothing could cheer them up, 41.5% calm and peaceful, 45.2% with high energy, 42% downhearted and blue, 87.7% worn out, 42.8% happy, and 90% tired. The psychological impact of LBP was associated with BMI (p=0.028), hours of sleep (p=0.008) and pain level estimated by VAS (p=0.002). However, we found no link between the psychological impact of LBP and other socio-demographic, clinical and working conditions data. Conclusion: LBP often has a psychological impact that should not be overlooked. We found an association between this psychological impact and BMI, sleep time and pain severity. An evaluation aiming to detect and manage this psychological impact must be part of the management of all LBP. REFERENCES: 1 Dickinson CE, Campion K, Foster AF, Newman SJ, O'Rourke AM, Thomas PG. Questionnaire development: an examination of the Nordic Musculoskeletal questionnaire. Appl Ergon. 1992 Jun;23(3):197-201. doi: 10.1016/0003-6870(92)90225-k. PMID: 15676868. 2 Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000 Nov 15;25(22):2940-52; discussion 2952. doi: 10.1097/00007632-200011150-00017. PMID: 11074683. 3 Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83. PMID: 1593914. Acknowledgements: NIL. Disclosure of Interests: None declared.