PSYCHOLOGICAL ASPECTS OF LOW BACK PAIN

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Abstract
Psychological studies relevant to back pain are reviewed. Clinical, epidemiological and psychometric studies show that when patients with back pain are drawn from the general population (e.g. industry) no relationship is found between pain and personality. When patients with back pain are selected for study (from general or hospital practice or through psychiatric referral) these patients show increased neuroticism, whether measured by personality test or assessed clinically, especially increased anxiety, depression and hysteria. Neither the chronicity of pain, nor the presence or absence of demonstrable organic pathology, has any consistent relationship to the personality test findings. Response to medical or surgical treatment, however, is worse in the psychoneurotic patients. The psychological contribution to the combined rheumatological and psychological assessment and management of back pain is outlined, and potentially fruitful areas for liaison research are suggested.

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