Several studies indicated that chronic low back pain (CLBP) worsened psychological distress (PD) and social participation (SP) improved PD. The relationships among CLBP, SP and PD have not been established. Here we investigate whether SP mediates the relationship between CLBP and PD in 96 elderly people. We evaluated CLBP and SP by a self-administered questionnaire and PD by K6 questionnaires. We used simple correlation analyses, the unpaired t-test, and a mediation analysis following the approach outlined by Structural Equation Modeling (SEM) to clarify the relationships among CLBP, SP and PD. Using SEM, was observed a significant relationship between CLBP and SP (β=-0.321, p=0.003), a significant negative correlation between SP and K6 scores (β=-0.357, p=0.001), and a significant positive correlation between CLBP and K6 scores (β=0.333, p=0.002). By including SP as a parameter, the coefficient of correlation between CLBP and K6 scores varied from 0.333 (p=0.002) to 0.218 (p=0.035). After bootstrapping, 0 was not included in the 95% confidence interval (0.119, 1.913). SP as a mediator may reduce PD in elderly people with CLBP.
Keywords: chronic low back pain; mediation analysis; psychological distress; social participation.