Poor general health and lower levels of vitality are associated with persistent, high-intensity low back pain and disability in community-based women: A prospective cohort study

While low back pain significantly impacts on an individual's well-being, our understanding of the role of well-being in the natural history of low back pain is limited. This cohort study aimed to investigate the association between psychological and general well-being and the development and progression of low back pain and disability in community-based women over a 2-year period. 506 women recruited from a research database were invited to participate. Overall psychological and general well-being and its subdomains were assessed at baseline using the Psychological General Well-Being Index (PGWB). The intensity of and degree of disability arising from low back pain were examined using the Chronic Pain Grade Questionnaire at baseline and at 2-year follow-up. Participants were categorized as having no, developing, resolving, or persistent high-intensity pain and disability. 444 participants (87.8%) completed the study. Women with persistent high-intensity pain had lower PGWB scores at baseline than those with no high-intensity pain at follow-up, after adjusting for confounders (M(SE) = 69.9(2.55) vs 80.1(2.63), p < 0.005). Furthermore, women with persistent high disability scores had lower well-being scores than those without persistent high disability scores (M(SE) = 69.1(3.49) vs. 81.2(0.802), p = 0.001). Moreover, lower scores in the well-being subdomains of general health and vitality were associated with persistent high pain intensity and disability (all p < 0.007). In summary, lower levels of general health and vitality were associated with persistent high-intensity low back pain and disability, suggesting that improving these aspects of well-being has the potential to reduce high levels of chronic low back pain and disability in community-based women.