Body image is more negative in patients with chronic low back pain than in patients with subacute low back pain and healthy controls

Abstract

<jats:title>Abstract</jats:title> <jats:sec id="j_sjpain-2018-0104_s_999"> <jats:title id="d2482991e38978">Background and aims</jats:title> <jats:p>Body image as an increasing research field has been integrated into pain research within the last years. However, research on cognitive-affective dimensions of body image dependent on different pain groups like acute/subacute and chronic pain patients, and healthy controls is still lacking. Therefore, this study aims to explore three dimensions of body image, namely self-acceptance, physical efficacy, and health in patients with low back pain and healthy controls. The present study is the first to distinguish between patients with low back pain in different stages of pain with regard to the concept of body image. In a second step we investigated the differences in exercise frequency between the three groups.</jats:p></jats:sec> <jats:sec id="j_sjpain-2018-0104_s_998"> <jats:title id="d2482991e38986">Methods</jats:title> <jats:p>Seventy seven patients (53.2% female) suffering from low back pain and 57 healthy controls (42.1% female) filled in a battery of questionnaires in terms of body image, pain parameters and exercise frequency.</jats:p></jats:sec> <jats:sec id="j_sjpain-2018-0104_s_997"> <jats:title id="d2482991e38994">Results</jats:title> <jats:p>Main results indicate first that patients suffering from chronic low back pain revealed a more negative body image in all three body image-dimensions than healthy controls. Second, patients suffering from subacute pain revealed a more negative body image of physical efficacy compared to the healthy controls.</jats:p></jats:sec> <jats:sec id="j_sjpain-2018-0104_s_996"> <jats:title id="d2482991e39002">Conclusions</jats:title> <jats:p>Our results suggest that body image is relevant for the treatment of low back pain, because patients suffering from low back pain revealed a more negative body image than healthy controls.</jats:p></jats:sec> <jats:sec id="j_sjpain-2018-0104_s_995"> <jats:title id="d2482991e39011">Implications</jats:title> <jats:p>To investigate the cognitive-affective dimensions of body image in different patient groups suffering from low back pain seems to be an important aspect for future research to improve therapy options and prevention of low back pain. Future research should also focus on improvements or on positive aspects of body image in patients with low back pain.</jats:p></jats:sec>

Body Image Relates to Exercise-Induced Antinociception and Mood Changes in Young Adults: A Randomized Longitudinal Exercise Intervention

“…Although our findings were centered on exercise-induced changes in ‘physical efficacy’, corroborating previous findings in chronic pain patients [ 41 ] we have to acknowledge that the observation of no significant changes in ‘health’ and ‘self-acceptance of one’s body’ is not in accord with the entire previous research literature [ 64 , 65 ]. We may speculate, however, that no changes in the individually perceived health status had to be expected in the context of this study, as all participants were healthy and young.…”

“…On the other hand, participants with a more positive body image are expected to have higher pain thresholds, an assumption that is also supported by the positive correlation between SKEF and HPT in the present study. Previous work has shown that the SKEF, in comparison to other components of the FKKS, is most closely related to pain states [ 41 ]: Patients with chronic or subacute pain states have a more negative body image of ‘physical efficacy’, as compared to healthy controls [ 41 ]. The current longitudinal data extend these cross-sectional findings in patients, by showing that AE modulates precisely the ‘physical efficacy’ dimension of the BI concept.…”

“…This is the first study exploring these three dimensions of BI on affective and antinociceptive outcomes in a randomized longitudinal intervention. Previous work demonstrated ‘physical efficacy’ to be the strongest factor determining negative BI in patients suffering from subacute pain, as compared to the healthy controls [ 41 ], hence, providing a specific hypothesis for this study.…”

Body Image in Athletes and Nonathletes With Low Back Pain: Avoidance–Endurance-Related Subgroups and Sports Status Play a Role

“…During the past decade, unfavorable facets of body image became of increasing interest, that is, perceptual aspects, such as misperceptions of the painful body part (eg, "I can't find it," "It feels as though it has shrunk" 14 ), and cognitive-affective aspects of body image, the latter referring to negative evaluations of one's own body with respect to self-acceptance (eg, "I have more physical deficits than others" 15 ), health (eg, "I often reach my physical limits" 15 ), and physical efficacy (eg, "I am strong" 15 ). [14][15][16][17] Recently, it has been shown that nonathletic patients with LBP reveal a more negative body image than healthy controls, although the direction of this relationship remains open. 17 However, there are inconsistent results regarding athletes.…”

Effect of Psycho-Regulatory Massage Therapy on Pain and Depression in Women with Chronic and/or Somatoform Back Pain: A Randomized Controlled Trial

“…Chou et al [ 10 ] underlined these recommendations and showed that psychological impairments, e.g., sleep disorders, mood fluctuation, depression, and listlessness, are frequent co-morbidities of chronic pain. A central characteristic of patients with chronic pain is their negative body perception [ 11 ], inhibiting cognitive access to therapy [ 12 , 13 , 14 ].…”