Author ORCID Identifier

Anitha Saravanan: https://orcid.org/0000-0002-4585-5577

Document Type

Article

Publication Title

Pain Management Nursing

Abstract

Purpose: Chronic low back pain is a prevalent condition, often involving an inflammatory process. Behavioral symptoms, including depressed mood, fatigue, and sleep disturbance, intensifies pain and reduces quality of life. The objectives of this pilot study were to identify behavioral symptom clusters (depressive mood, fatigue, poor sleep) in individuals with chronic low back pain, and to determine whether there are differences in pain, quality of life and inflammation (plasma IL-6) based on cluster membership.

Design and Methods: In a cross-sectional pilot study, patients (N=69) completed measures of pain, depressive mood, fatigue, sleep, and quality of life. Blood was obtained for IL-6 measurement. Latent class analysis was used to identify clusters. Results: Findings revealed a two-class model, with Class 1 characterized by more depressive mood, fatigue, and sleep disturbance compared to Class 2. Class 1 participants reported worse quality of life than those in Class 2. Pain severity and pain interference were not significantly different between the classes. Levels of IL-6 were significantly greater in Class 1 participants compared to Class 2 with higher levels of IL-6 correlating with greater pain severity and sleep disturbances. Logistic regression revealed higher levels of IL-6 predicted Class 1 membership.

Conclusion: Behavioral symptoms cluster exist in chronic low back pain patients and impact quality of life. Inflammation may contribute to the relationship between behavioral symptoms and pain severity.

Clinical Implications: Recognition of behavioral symptom clusters can foster more comprehensive pain assessment and tailored interventions for patients with chronic low back pain.

First Page

361

Last Page

368

DOI

10.1016/j.pmn.2020.11.012

Publication Date

6-2021

Comments

© 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/. This is an Accepted Manuscript of an article published by Elsevier in Pain Management Nursing in Jun 2021, available at: https://doi.org/10.1016/j.pmn.2020.11.012

Original Citation

Saravanan A, Bajaj P, Mathews HL, Tell D, Starkweather A, Janusek L. Behavioral Symptom Clusters, Inflammation, and Quality of Life in Chronic Low Back Pain. Pain Manag Nurs. 2021 Jun;22(3):361-368. doi: 10.1016/j.pmn.2020.11.012

Department

School of Nursing

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