The correlation between illness perception, pain intensity and quality of life in elderly with low back pain in Denmark: a cross-sectional study

PeerJ. 2022 Oct 14:10:e14129. doi: 10.7717/peerj.14129. eCollection 2022.

Abstract

Background: Illness perception is related to management patterns and pain intensity, but among elderly with low back pain, this relation is unclear. The aims of this study were to analyse the associations between illness perception, pain intensity and health related quality of life in a group of elderly with low back pain and explore how different illness perception profiles would cluster and differ in terms of pain, quality of life and choice of management.

Method: This was a cross-sectional survey based on a cohort of originally 640 Danish children. Of the 311 respondents in 2019, 69% reported low back pain within last year and were included. Associations between illness perceptions (Brief illness perception questionnaire), health related quality of life (EuroQol-5 Domain-3L) and low back pain intensity were assessed, and participants were clustered based on their perceptions using hierarchical and K-means cluster analysis. Cluster differences in pain, quality of life and use of pharmacological and non-pharmacological treatments were explored.

Results: Among the 213 individuals with low back pain, 33% reported severe or fluctuating pain intensity. Higher pain intensity was associated with perceiving low back pain as a greater threat. Participants reporting fluctuating pain perceived their low back pain almost as threatening as participants reporting severe pain. Two clusters were identified. Cluster 1 reported lower quality of life (difference in medians: -0.176 (95% CI [-0.233--0.119 ])) and was more likely to report severe or fluctuating pain (37.7% vs. 4.5% [P < 0.0001]) and to use pharmacological treatments than Cluster 2 (37.7% vs. 14.9% [P < 0.001]). No association was found between clusters concerning use of non-pharmacological treatments (P = 0.134).

Conclusion: Based on illness perceptions, two clusters differing in pain intensity, quality of life and use of pharmacological treatments were identified. Targeting illness perceptions may be beneficial during rehabilitation or when guiding patients with low back pain in choice of management.

Keywords: Cross sectional study; Illness perception; Low back pain; Pain management; Quality of life; Survey.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Child
  • Cross-Sectional Studies
  • Denmark / epidemiology
  • Humans
  • Low Back Pain* / epidemiology
  • Pain Measurement
  • Pain Perception
  • Quality of Life

Grants and funding

This research study received no specific funding but the “Elsinore Cohort” was funded by The Danish Rheumatism Association (grant number: (R175-A6097). The Parker Institute, Bispebjerg and Frederiksberg Hospital is supported by a core grant from the 585 Oak Foundation (OCAY-18-774-OFIL). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.