433: Associations of Pain Resilience with Disability, Sleep, Anxiety and Depression in Low Back Pain

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Psychology, Assessment and Measurement of Pain/Nociception, Quantitative Sensory testing (static and dynamic, e.g., HPT, PPT, CPM, TSP, offset analgesia)

Background and Aims: Low back pain is highly prevalent in the general population and a leading cause of disability worldwide (1). Pain resilience may be an important factor influencing pain-related outcomes, yet its association with clinical and psychosocial variables remains insufficiently understood. This study aimed to investigate the associations between the biopsychological pain resilience core and pain, disability, sleep quality, anxiety, and depression in individuals with chronic low back pain.

Methods: Thirty-five individuals with chronic low back pain were included [age: 50 (39/55) years, Body Mass Index: 25.77 (24.33/30.11) kg/m2]. Biopsychological Pain Resilience Core was a composite index of Conditioned Pain Modulation, Central Sensitization Inventory, and Pain Self-Efficacy Questionnaire scores. The Visual Analog Scale, the Oswestry Disability Index, the Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression Scale were used. Pearson and Spearman correlation tests were performed.

Results: The pain resilience showed negative correlations with study outcomes. Weak associations were observed with resting pain (r=−0.340, p=0.045), night pain (r=−0.357, p=0.035), and sleep latency (r=−0.363, p=0.032). Moderate correlations were found with activity-related pain (r =−0.486, p =0.003), subjective sleep quality (r =−0.539, p =0.001), sleep duration (r =−0.496, p =0.002), sleep disturbance (r =−0.597, p< 0.001), daytime dysfunction (r =−0.515, p=0.002), overall sleep quality score (r =−0.537, p=0.001), anxiety (r=−0.469, p=0.004), and depression (r=−0.453, p=0.006). A strong correlation was observed with disability (r=−0.632, p< 0.001).

Conclusions: Higher pain resilience is associated with lower pain intensity, disability, anxiety and depression, and better sleep quality. The strongest association was observed with disability, whereas a weaker association was found with resting pain intensity. These findings suggest that pain resilience is more strongly related to functional status.

References: 1. GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5:e316–e329.

Presenting Author: Sevinc Akdeniz
Submitting Author: Sevinc Akdeniz

Senior Author: Sevinc Akdeniz

IASP 2026 Global Year theme of Neuropathic Pain: No

• Sevinc Akdeniz: MSc - Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
• Zafer Ucurum: BSc - Physical Therapy Unit, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
• Derya Ozer Kaya: PhD, Prof. - Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.