Relationship between the intensity of chronic low back pain and the generated limitations with depressive symptoms

Donatti, Ariel; Alves, Élen dos Santos; Terassi, Mariélli; Luchesi, Bruna Moretti; Pavarini, Sofia Cristina Iost; Inouye, Keika

doi:10.5935/2595-0118.20190044

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ORIGINAL ARTICLES • BrJP 2 (3) • Jul-Sep 2019 • https://doi.org/10.5935/2595-0118.20190044 copy

Relationship between the intensity of chronic low back pain and the generated limitations with depressive symptoms

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Aging adds to the prevalence of chronic diseases and functional impairment. Depressive symptoms and chronic low back pain affect an increasing number of elderly people and become important research topics. This study aimed to identify the relationship between chronic low back pain intensity, its generated disability, and the presence of depressive symptoms in independent elderly people for basic daily activities.

METHODS:

The study is descriptive, quantitative, and cross-sectional. A sample of independent elderly patients with chronic low back pain (n=46) enrolled in the Family Health Units of the city of São Carlos, SP, Brazil, was analyzed. For collection, we used the Characterization Sheet, Multidimensional Pain Rating Scale, Roland-Morris Disability Questionnaire, and the Geriatric Depression Scale. The data obtained were input in the Statistical Package for Social Sciences software (SPSS) for Windows to perform the descriptive and Spearman correlational analysis. The ethical precepts for research with humans of the National Health Council were respected.

RESULTS:

The most frequent pain intensity perceived by the elderly was intense (43.5%, n=20), preceded by moderate pain (41.3%, n=19). Most of the elderly describe low back pain as persistent, painful, and uncomfortable. The mean total depression score was 4.37 points (Md=4.00, SD=2.67, x_min = 0.00, x_max = 11.00).

CONCLUSION:

Correlational analyses showed that there is a significant directly proportional relationship between the intensity of low back pain and the number of weak depressive symptoms, and a significant directly proportional relationship between the number of disabilities/limitations caused by low back pain and the number of moderate depressive symptoms.

Keywords:
Chronic pain; Depression; Disability; Gerontology; Health of the elderly; Low back pain

Variables	Frequency (n)	Proportion (%)
Gender
Female	41	89.1
Male	5	10.9
Total	46	100.00
Marital status
With partner	44	84.8
Single	1	2.2
Widow	1	2.2
Total	46	100.00
Retired
Yes	24	52.2
No	22	47.8
Total	46	100.00
Education
Never went to school.	12	26.1
Basic literacy	3	6.5
1-4 years of study	25	54.3
5-9 years of study	3	6.5
9 years or more of study	3	6.5
Total	46	100.00
Religion
Catholic	29	63.0
Others	16	36.6%
No religion	1	2.2
Total	46	100.00
Ethnic group
White	36	78.3
Black	5	10.9
Brown	5	10.9
Total	46	100.00
Sufficient income
No	29	63.0
Yes	17	37.0
Total	46	100.00
Health insurance
No	39	84.8
Yes	7	15.2
Total	46	100.00

Intensity of perceived pain	Absolute frequency (n)	Relative frequency (%)
None (0)	1	2.2
Mild (1 to 3)	-	-
Moderate (4 to 6)	19	41.3
Intense (7 to 9)	20	43.5
Unbeatable (10)	6	13

Pain descriptors	Frequency
Pain descriptors	Yes (n and %)		No (n and %)
Depressing	28	60.9	18	39.1
Persistent	35	76.1	11	23.9
Distressing	30	65.2	16	34.8
Disastrous	21	45.7	25	54.3
Harmful	32	69.6	14	30.4
Painful	42	91.3	4	8.7
Unbearable	28	60.9	18	39.1
Frightening	20	43.5	26	56.5
Cruel	23	50	23	50
Uncomfortable	43	93.5	3	6.5

Items of the Geriatric Depression Scale	AF (n)		RF (%)
Items of the Geriatric Depression Scale	Yes	No	Yes	No
1. Are you satisfied with your life?	39	7	84.8	15.2
2. Have you given up many of your interests and activities?	25	21	54.3	45.7
3. Do you feel that your life is empty?	15	31	32.6	67.4
4. Do you get bored frequently?	17	29	37.0	63.0
5. Do you feel in a good mood most of the time?	39	7	84.8	15.2
6. Are you afraid that something bad will happen to you?	26	20	56.5	43.5
7. Are you happy most of the time?	40	6	87.0	13.0
8. Do you feel that your situation has no way out?	8	38	17.4	82.6
9. Would you rather stay at home instead of going out and doing new things?	24	22	52.2	47.8
10. Do you think you have more memory problems than most of the people?	17	29	37.0	63.0
11. Do you think it's wonderful to be alive?	44	2	95.7	4.3
12. Do you feel useless in the present circumstances?	9	37	19.6	80.4
13. Do you feel full of energy?	30	16	65.2	34.8
14. Do you think your situation is hopeless?	7	39	15.2	84.8
15. Do you think that most people are better than you?	15	31	32.6	67.4

Items of the Roland Morris Disability Questionnaire	AF (n)		RF (%)
Items of the Roland Morris Disability Questionnaire	Yes	No	Yes	No
1. I stay at home most of the time because of my pain	29	17	63.0	37.0
2. I change position frequently trying to be more comfortable with my pain	13	33	28.3	71.7
3. I walk slower than usual because of the pain	17	29	37.0	63.0
4. Because of the pain, I'm not doing some of the tasks I usually do at home	21	25	45.7	54.3
5. Because of the pain, I use the handrail to climb stairs	19	27	41.3	58.7
6. Because of the pain, I frequently have to lie down to rest.	24	22	52.2	47.8
7. Because of the pain, I have to lean on things to get up from an armchair	21	25	45.7	54.3
8. Because of the pain, I let other people do things for me.	32	14	69.6	30.4
9. I dress more slowly than usual because of my pain	19	27	41.3	58.7
10. I can only be standing for a short time because of the pain	23	23	50.0	50.0
11. Because of the pain, I try not to bend down or kneel	14	32	30.4	69.6
12. It is difficult to get up from a chair because of the pain	26	20	56.5	43.5
13. I feel pain almost all the time	23	23	50.0	50.0
14. It is difficult to turn in bed because of the pain	21	25	45.7	54.3
15. My appetite is not very good because of my pain.	38	8	82.6	17.4
16. I have trouble putting my socks on because of the pain	33	13	71.7	28.3
17. I walk only short distances because of my pain	23	23	50.0	50.0
18. I do not sleep so well because of the pain	26	20	56.5	43.5
19. Because of pain, I need other people's help to get dressed	37	9	80.4	19.6
20. I stay seated most of the time because of my pain	35	11	76.1	23.9
21. I avoid heavy work at home because of my pain	14	32	30.4	69.6
22. Because of the pain, I am more annoyed and grumpier with people than in general	23	23	50.0	50.0
23. Because of the pain, I climb stairs slower than usual	15	31	32.6	67.4
24. I lie in bed (lying down or sitting) most of the time because of my pain	34	12	73.9	26.1

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[1] Correspondence to: Rodovia Washington Luís Km 235-SP-310 13565-905 São Carlos, SP, Brasil. E-mail: elendutra23@gmail.com