Author ORCID Identifier

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

Document Type

Article

Publication Title

Nursing Research

Abstract

Background

Chronic low back pain (CLBP) is a significant cause of disability, lost wages, and healthcare costs. Inflammatory mediators, such as interleukin-6 (IL-6), have been associated with LBP severity. Patients with CLBP commonly experience sleep disturbance, and poor sleep has been shown to increase pain severity and inflammation. In contrast, social support may benefit patients with CLBP by reducing pain intensity and inflammation.

Objectives

The purpose of this study was to examine the influence of social support on the relationships among sleep disturbance, inflammation, and pain severity in patients with CLBP.

Methods

In a cross-sectional study, men and women with CLBP were enrolled from an outpatient pain clinic. Participants completed psychometric instruments for social support, sleep quality, and pain severity. Blood samples were obtained for measurement of the pro-inflammatory cytokine IL-6 by enzyme-linked immunoassay.

Results

Linear regression revealed greater sleep disturbance predicted greater pain severity. In contrast, participants who reported higher social support had lower sleep disturbance and lower pain severity. Mediation analysis revealed sleep disturbance to mediate the relationship between social support and pain, such that sleep disturbance reduced the benefit of social support on pain severity. Furthermore, greater sleep disturbance and lower social support predicted increased IL-6. However, IL-6 did not mediate the relationship between social support and pain.

Discussion

The findings suggest that increased social support is associated with lower sleep disturbance, lower inflammation, and lower pain severity in patients with CLBP. Assessing the extent of social support and fostering social support as part of a comprehensive pain management program may benefit patients with CLBP. Interventions to strengthen social support systems and cultivate support from family and/or informal social networks may reduce symptom burden and improve quality of life.

First Page

425

Last Page

432

DOI

10.1097/NNR.0000000000000543

Publication Date

11-2021

Comments

This is a non-final version of an article published in final form in Saravanan A, Bajaj P, Mathews HL, Tell D, Starkweather A, Janusek L. Social Support Is Inversely Associated With Sleep Disturbance, Inflammation, and Pain Severity in Chronic Low Back Pain. Nurs Res. 2021 Nov-Dec 01;70(6):425-432. https://doi.org/10.1097/nnr.0000000000000543

Original Citation

Saravanan A, Bajaj P, Mathews HL, Tell D, Starkweather A, Janusek L. Social Support Is Inversely Associated With Sleep Disturbance, Inflammation, and Pain Severity in Chronic Low Back Pain. Nurs Res. 2021 Nov-Dec 01;70(6):425-432. doi: 10.1097/NNR.0000000000000543

Department

School of Nursing

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