Chronic low-back pain, psychologic distress, and illness behavior.

The authors have calculated the mathematic relationship between measured elements of illness behavior in chronic low-back pain. Objective physical impairment accounts for about one-half the total disability that also is affected by psychologic reactions. The most important psychologic disturbance in low-back pain is emotional distress, measured on questionnaires as increased bodily awareness and depression and presenting clinically as inappropriate descriptions of symptoms and inappropriate responses to physical examination. Simple methods for the assessment of distress and illness behavior in chronic low-back pain are developed and described.