Clinical impact of JOABPEQ mental health scores in patients with low back pain: Analysis using the neuropathic pain screening tool painDETECT.

BACKGROUND: In patients with low back pain (LBP) who combine psychosocial factors with clinical findings of pain, there is a possibility that the psychosocial factors modify the pain. In the current study, we investigated the relationship between the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) mental health score and the characteristics of LBP.

METHODS: Of 650 patients with LBP, 319 were excluded, leaving 331 patients included in this study. All patients between the ages of 20 and 79 were asked to complete a set of questionnaires including the Japanese version of the painDETECT (PDQ-J), Numeric Rating Scale (NRS), the JOABPEQ, and the Short Form 36 (SF-36). Based on their JOABPEQ mental health scores, the patients were divided into two groups: those with JOABPEQ mental health score of <50 were classified as low score group, and those scoring ≥50 were classified as the high score group. To identify any differences between the two groups, age, sex, PDQ-J score, NRS score, duration of symptoms, percentage of pain components, percentage of lower limb symptoms and self-reported general health were compared.

RESULTS: 196 patients (59.2%) were classified into the low score group, and 135 (40.8%) into the high score group. The mean PDQ-J and NRS scores and percentage of LBP patients with neuropathic pain and lower limb symptoms were higher in the low score group. We also evaluated the relationship between lower limb symptoms and JOABPEQ mental health scores in 331 LBP patients. The results show that a significantly greater number of LBP patients in the low mental score group had lower limb symptoms compared to the high mental score group.

CONCLUSION: We found that psychological factors may modify pain intensity and may lead to an exaggerated or histrionic presentation of the pain, or neuropathic LBP may be exacerbating psychological factors.