[Type D personality style and back pain : A narrative overview of the relevance of psychosocial factors in orthopedic pain therapy].

BACKGROUND

The Type D personality ("distressed personality") is characterized by a combination of negative affectivity and social inhibition. While this personality style was originally researched in the context of cardiovascular disease, recent studies also show a significant association with chronic pain disorders, especially back pain.

OBJECTIVES

This narrative review examines the current state of knowledge on the relationship between type D personality and back pain. The aim is to analyze possible psychological, behavioral, and biological mechanisms and to derive clinical implications for orthopedic pain therapy.

MATERIALS AND METHODS

A selective literature search was conducted in the PubMed, PsycINFO and Google Scholar databases. Original studies, systematic reviews and meta-analyses from the last 20 years focusing on psychosomatic aspects of chronic back pain were included.

RESULTS

Several studies show that individuals with Type D characteristics have an increased risk of developing and chronicizing back pain. Possible mediating mechanisms include maladaptive stress processing, somatisation, reduced social support and changes in neuroendocrine and inflammatory processes.

CONCLUSIONS

Type D personality is a relevant psychosocial risk factor in the development and persistence of chronic back pain. Early detection may contribute to improving multidisciplinary therapeutic approaches.