This study attempted to examine stressful life events in patients with idiopathic low back pain. The researchers took into account individual predisposition and the psychosocial resources available during the stressful life episode. The study divided 64 low back pain patients into two categories, those with organic causes (16 patients) and those with an uncertain etiology (48 patients).
The most frequently cited stressful life events included "severe illness of family member or close friend," "loss of job," and "divorce." When comparing the two groups of patients, the researchers found no difference in the kindand number of stressful life events. However, the idiopathic group recalled the events as significantly stressful, causing long lasting disturbances in their daily life. The idiopathic patients showed difficulty in coping with these events and a lack of support—which then sparked feelings of helplessness and exhaustion—contributing to chronic low back pain.
The researchers suggest:
"In the assessment of these patients, the attending physician should pay special attention to highly stressful events while taking the history of the present illness, in particular those events that create feelings of helplessness and exhaustion in their patients. Our results might help determine which patients stand in need of psychotherapeutic support or, in case of marked depression, of additional antidepressant medication and thus help prevent the onset of chronicity in patents with idiopathic low back pain."
Lampe A, Sollner W, Krismer M, et al. The impact of stressful life events on exacerbation of chronic low back pain. Journal of Psychosomatic Research 1998;44(5):555-563.