Psychologic factors in low-back-pain disability.

UNLABELLED

Biomechanical tests, physical examination, spinal radiographs, a modified Minnesota Multiphasic Personality Inventory (MMPI), and a psychologic health inventory derived from the Hopkins Symptom Checklist were applied in 321 randomly selected men, ages 18-55. Each subject was evaluated for prior and current low-back pain (LBP) complaints by use of a modification of the McGill pain questionnaire. Subjects were then categorized as having no LBP (n = 106, 33%), moderate LBP (n = 144, 44.8%), and severe LBP (n = 71, 22.1%). Subjects were further subcategorized as not disabled (defined as equal or less than seven days of work lost in the previous year) and disabled (work loss greater than seven days in the prior year).

RESULTS

cumulative scores of the Hopkins Checklist showed that a mean score for no LBP equaled 2.5 +/- 2.9; moderate LBP was 4.3 +/- 3.2; and severe LBP was 4.6 +/- 3 (p = .0000). The disabled group was significantly different on both MMPI and Hopkins Checklist. The 20 disabled subjects had significant elevations of hypochondriasis (p = .0006) and hysteria (p = .005) when compared with nondisabled subjects with LBP. The mean score for disabled subjects on the Hopkins Checklist was 7.35 +/- 4.49, while the score was 4.17 +/- 3.15 (p = .0001) for the nondisabled subjects with LBP. In the general male population, patients with disabling LBP conditions form a distinctive subgroup comparable to those patients seen in selected LBP clinics.