ASSOCIATION OF SOMATIC SYMPTOM DISORDERS (SSDs) WITH PAIN, DISABILITY AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP). PRILIMINARY FINDINGS

Objective: To investigate changes in pain, disability, anxiety, depression, somatic symptom burden and quality of life among patients with CLBP after the implementation of a physiotherapy regimen, and to examine the association of SSDs with the above parameters.
Materials and methods: Patients with CLBP recruited using random systematic sampling and completed a battery of questionnaires, the Numerical Pain Scale (NPS) for pain, the Rolland-Morris for disability (RMQ), the EuroQoL 5-dimension 5-level (EQ-5D-5L) for health status, the Somatic Symptom Scale-8 (SSS-8) for SSDs, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression. A paired t-test, Wilcoxon signed test and McNemar test were used for quantitative, ordinal and qualitative variables respectively. Pearson’s correlation coefficient r was tested examining associations between SSS-8 and NPS, RMQ, EQ-5D-5L and HADS. The level of statistical significance was set at p<0.05.
Results: 32 subjects participated of which 13 were male, mean age 57.3 years (16,4), 46.9% were overweight and 18.8% obese. After treatment, significant reductions were observed in pain intensity [from 5.06 (2.17) to 3.46 (2.02)], disability [from 7.44 (4.70) to 6.31 (5.56)] and somatic symptom burden [from 9.25 (4.59) to 7.81 (4.13)]. Additional improvement was found in mean EQ-5D-5L VAS score [from 69.66 (13.54) to 76.23 (15.81)], but no in EQ-5D-5L index value, anxiety and depression. Level of pain was improved significant, since 28.1% of patients mentioned severe pain in the beginning and the corresponding proportion was 7.7% after the treatment, while in contract frequency of having regular exercising more than twice per week remained stable at the baseline and at the end of intervention (43.8% and 42.3%, respectively). A moderate negative correlation was noted between primary score of SSS-8 and EQ-5D-5L VAS (r=-0.46), whereas a moderate positive association was found between SSS-8 and NPS change (r=0.39).
Conclusion: Physiotherapy regimen was shown to be effective in patients with CLBP, by improving pain, disability, SSDs and health status. A somatic symptom burden was significant correlated with pain and health-related quality of life.