Abstract

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The present study investigated the specific nature of the traumatic event in patients with chronic low back pain (CLBP). Specifically, the following questions were asked: (1) Do individuals with CLBP evidence posttraumatic stress disorder?, (2) In patients with CLBP, what is the trauma which predicts the development of PTSD- the specific event which led to the lower back pain, any other traumatic event, or is it the chronic low back pain itself which is traumatic? (3) In CLBP patients who evidence PTSD, do the intensity and duration of the trauma predict the development of PTSD? Participants were 112 patients receiving treatment for their CLBP at Loma Linda University Medical Center and Health Care facilities. The present study involved self-reports of pain intensity, traumatic experiences. and posttraumatic stress disorder.

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Participants were grouped into four categories in order to further clarify the nature of the traumatic event, including: (1) with pain only, without previous trauma, (2) with pain who experienced previous general trauma, which did not specifically lead to CLBP, (3) with pain who experienced specific trauma that led to their CLBP condition, but who did not experience any other previous trauma, and (4) with pain who experienced both general trauma and specific trauma. The majority (89%) of CLBP patients evidenced some level (mild-severe) of posttraumatic stress disorder, with the average CLBP patient having PTSD at the moderate level. Comparatively, the normative population, on-average, scored in the moderate-severe range for PTSD. The intensity and duration of the trauma did not significantly predict PTSD in these patients. Patients in the "pain w/general trauma only" group had the highest means for PTSD. The level of perceived pain severity was the only significant predictor of PTSD; therefore, CLBP patients who are experiencing more severe CLBP are more likely to manifest PTSD. The results of the present study indicate that. while it is not possible to exclude other factors which may play a role in the development of PTSD, it is clear that the severity of the chronic low back pain significantly predicts PTSD. Furthermore, the experience of pain with previous trauma with CLBP may compound the affective distress that these patients experience, which reflects in higher levels of PTSD.