“Blue flags” of pain such as an important factor, has been influenced in the chronification of the low back pain

BACKGROUND. Despite the widely discussed problem of pain chronification, the issues of assessing the relationship between emotional-affective disorders and the social status of patients with pain in the context of assessing the so-called “blue flags” of pain remain poorly understood.

AIM. To determine the relationship between biopsychosocial factors, particularly socioeconomic status, and the quality of life of patients with back pain.

MATERIAL AND METHODS. The study included 32 patients suffering with non-specific back pain of various localization. During of the study, the results of neuropsychological tests (HADS, SF-36, VAS) were analyzed to assess the mental state and social aspects of the patients’ lives. A specially designed questionnaire was used to assess the so-called “blue flags” of pain, which including the level of satisfaction with work and relationships in the workplace. The statistical processing of the data obtained was carried with using the programe Statistica 6.0 with the evaluation of Student’s criterion and Pearson’s coefficient.

RESULTS. Correlations were found between emotional-affective disorders and socio-economic aspects, namely: job satisfaction and relationships with colleagues. Emotional and affective disorders were found to have a significant impact on relationships at work. People with emotional-affective disorders and chronic pain syndrome are more likely to have an unsatisfactory self-assessment of their health. The relationship between emotional-affective disorders and the intensity of the pain syndrome and life impairment was also determined, and it was found that patients with psychological distress are more susceptible to life impairment due to back pain. In the process of determining the level of quality of life of the examined individuals, low values were found according to the SF-36 questionnaire due to a decrease in the psychological component of health in patients with chronic pain syndrome (r=0.64, p <0.05). Significant correlations were found between affective disorders and job satisfaction (r=–0.46, p <0.05) and relationships with co-workers (r=–0.44, p <0.05), as well as pain intensity according to VAS (r=–0.37, p <0.05).

CONCLUSION. Socio-economic factors, the so-called “blue flags” of pain, together with emotional and affective disorders, have a significant impact on the outcome of the pain syndrome and largely determine the chronification of pain, with a regression in the quality of life of patients with back pain.