Chronic low back pain among athletes: how is it related to physical and mental stress?

Abstract

Background: Low back pain (LBP) ranges among the most impairing musculoskeletal diseases with several factors contributing to the development and chronification of the burden. Predominantly, psychological stress has emerged as a crucial influence in the general population, but has barely been scrutinized as an influence for athletes with LBP. Hence, the present study aimed at the comparison of different facets of stress with regard to pain and disability indicators of LBP chronification. Methods: A longitudinal study with an overall sample of 139 athletes was conducted. At T0, stress parameters were assessed via the Recovery-Stress Questionnaire (RESTQ-Basic) and the Screening Scale of the Trier Inventory for the Assessment of Chronic Stress (TICS-SSCS). Both at T0 and T1 (six-month later), different chronification indicators were measured, targeting the parameters of pain intensity and disability (Chronic Pain Grade). As a consequence of the assessment of the LBP parameters, a chronification and no-chronification group of athletes was formed. Results: ANCOVAs were calculated to examine group differences with regard to stress levels. On a descriptive level, the chronification groups showed higher stress values for all included chronification indicators. Physical Complaints and Overall Stress-TICS resulted to be the variables for which the group differences became significant (p < .05). Conclusions: The outcomes contribute to the current state of research by adding specific knowledge about stress-related dissimilarities between athletes with and without LBP chronification over a period of six months. Both future research and practice regarding injury prevention and monitoring of health-related processes can benefit from the findings.