Passive coping is a risk factor for disabling neck or low back pain

Background: Despite evidence suggesting that coping is an important concept in the study of pain, its role in predicting the development of disabling pain has not been previously studied. To assess the relationship between coping and the development of disabling pain. Methods: From a random sample of adults, we formed a cohort of individuals with non-disabling neck and/or low back pain (n=571). Participants were followed 6 and 12 months after the index survey. Coping was measured with the Vanderbilt Pain Management Inventory. The Chronic Pain Questionnaire was used to measure the presence of disabling neck and/or low back pain. We used Cox proportional hazards regression analyses to investigate the role of passive coping in the development of disabling pain while controlling for confounders. Results: Passive coping was a strong, independent risk factor for disabling neck and/or back pain. Those using moderate to high levels of passive coping strategies were at an over five-fold increased risk of developing disabling pain (Moderate: HRR=5.19, 95% CI=1.78-15.1; High: HRR=6.80, 95% CI=2.36-19.6). Active coping was not found to be a significant risk factor for disabling neck and/or back pain. Conclusion: Passive coping is a strong and independent predictor of disabling neck and/or back pain. This strong relationship identifies passive coping as a marker for risk of disability and can allow for the identification of individuals at risk and in need of intervention to aid in improving their overall adjustment.