Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety

Hani AlHarthi; Ahmad Bilal; Hind AlMalki; Fahad Alzahrani; Ahmed Ibrahim; Hisham Hussein; Mostafa Abdel-fattah; Doaa Omar; Ibrahim Dewir

doi:10.5114/areh.2025.146633

ISSN: 1734-4948

Advances in Rehabilitation

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abstract:

Original article

Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety

Hani AlHarthi

¹

,

Ahmad Bilal

¹

,

Hind AlMalki

¹

,

Fahad Ali Alzahrani

²

,

Ahmed Abdelmoniem Ibrahim

^{3, 4}

,

Hisham Mohamed Hussein

^{3, 5}

,

Mostafa S. Abdel-fattah

⁶

,

Doaa I. Omar

⁷

,

Ibrahim Metwally Dewir

⁶

Department of Physiotherapy, Armed Forces Center for Health Rehabilitation, Taif, Saudi Arabia
Department Physiotherapist in comprehensive rehabilitation, Taif, Saudi Arabia
Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
Department of Physical Therapy, Cairo University Hospitals, Cairo, Egypt
Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
Department Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Benha University, Egypt

Adv Rehab. 2025. 39(1): 33-45

DOI: https://doi.org/10.5114/areh.2025.146633

Online publish date: 2025/01/13

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AMA

AlHarthi H, Bilal A, AlMalki H, et al. Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety. Advances in Rehabilitation. 2025;39(1):33-45. doi:10.5114/areh.2025.146633.

APA

AlHarthi, H., Bilal, A., AlMalki, H., Alzahrani, F. A., Ibrahim, A. A.,  & Hussein, H. M. et al. (2025). Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety. Advances in Rehabilitation, 39(1), 33-45. https://doi.org/10.5114/areh.2025.146633

Chicago

AlHarthi, Hani, Ahmad Bilal, Hind AlMalki, Fahad A Alzahrani, Ahmed A Ibrahim, Hisham M Hussein,  and Mostafa S Abdel-fattah et al. 2025. "Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety". Advances in Rehabilitation 39 (1): 33-45. doi:10.5114/areh.2025.146633.

Harvard

AlHarthi, H., Bilal, A., AlMalki, H., Alzahrani, F., Ibrahim, A., Hussein, H., Abdel-fattah, M., Omar, D.,  and Dewir, I. (2025). Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety. Advances in Rehabilitation, 39(1), pp.33-45. https://doi.org/10.5114/areh.2025.146633

MLA

AlHarthi, Hani et al. "Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety." Advances in Rehabilitation, vol. 39, no. 1, 2025, pp. 33-45. doi:10.5114/areh.2025.146633.

Vancouver

AlHarthi H, Bilal A, AlMalki H, Alzahrani F, Ibrahim A, Hussein H et al. Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety. Advances in Rehabilitation. 2025;39(1):33-45. doi:10.5114/areh.2025.146633.

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Introduction
Patients with non-specific chronic lower back pain (LBP) who do not improve after physical therapy have high levels of anxiety, depression, and kinesiophobia. This study examines the effect of anxiety on pain, functional disability, and psychological characteristics in patients with LBP.

Material and methods
A cross-sectional study was performed on 60 Saudi patients aged 18-65 years old with chronic nonspecific lower back pain from January to July 2024. The data was acquired using the Generalized Anxiety Disorder-7 (GAD-7), Numeric Pain Rating Scale (NPRS), Tampa Scale, The Roland-Morris Disability Questionnaire (RMDQ), Fear-Avoidance Beliefs Questionnaire (FABQ), Quality of Life using 36-Item Short-Form Health Survey questionnaire (RAND SF 36), and The Pittsburgh Sleep Quality Index (PSQI).

Results
Thirty participants had a GAD score below 10, while the other 30 had scores above 10. Significant differences in pain intensity, psychological and disability function were noted between the two groups, as indicated by NPRS (z = -2.42, p-value = 0.01), Tampa scale (z = - 3.22, p-value = <0.001), RMDQ (z = -3.58, p-value = <0.001), PSQI (z = 0.32, p-value = 0.03), and FABQ (z = - 2.27, p-value = 0.02). The correlations between anxiety and pain intensity, level of disability, and psychological function were examined using Spearman’s correlation analysis.

Conclusions
Among patients with non-specific chronic LBP, anxiety influences pain intensity, psychological functioning, and disability. There is hence a need for comprehensive evaluations and tailored interventions by clinicians and physical therapists.

keywords:

low back pain, mood disorder, psychological factor, quality of life

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Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety

Hani AlHarthi 1 , Ahmad Bilal 1 , Hind AlMalki 1 , Fahad Ali Alzahrani 2 , Ahmed Abdelmoniem Ibrahim 3, 4 , Hisham Mohamed Hussein 3, 5 , Mostafa S. Abdel-fattah 6 , Doaa I. Omar 7 , Ibrahim Metwally Dewir 6

low back pain, mood disorder, psychological factor, quality of life

Hani AlHarthi

¹

,

Ahmad Bilal

¹

,

Hind AlMalki

¹

,

Fahad Ali Alzahrani

²

,

Ahmed Abdelmoniem Ibrahim

^{3, 4}

,

Hisham Mohamed Hussein

^{3, 5}

,

Mostafa S. Abdel-fattah

⁶

,

Doaa I. Omar

⁷

,

Ibrahim Metwally Dewir

⁶