Bio-psychosocial factors are associated with pain intensity, physical functioning, and ability to work in female healthcare personnel with recurrent low back pain

Objective: To investigate associations of various bio-psychosocial factors with bodily pain, physical func-tioning, and ability to work in low back pain. Design: Cross-sectional study. Subjects: A total of 219 female healthcare workers with recurrent non-specific low back pain. Methods: Associations between several physical and psychosocial factors and: (i) bodily pain, (ii) physical functioning and (iii) ability to work were studied. Variables with statistically significant associations (p < 0.05) in bivariate analysis were set within a generalized linear model to analyse their relationship with each dependent variable. Results: In generalized linear model analysis, perceived work-induced lumbar exertion (p < 0.001), multi-site pain (p< 0.001) and work-related fear-avoidance beliefs (FAB-W) (p = 0.02) best explained bodily pain. Multi-site pain (p < 0.001), lumbar exertion (p = 0.005), FAB-W (p = 0.01) and physical performance in figure-of-eight running (p = 0.01) and modified push-ups (p = 0.05) best explained physical functioning; FAB-W (p< 0.001), lumbar exertion (p = 0.003), depression (p = 0.01) and recovery after work (p = 0.03) best explained work ability. In bivariate analysis lumbar exertion was associated with poor physical performance. Conclusion: FAB-W and work-induced lumbar exertion were associated with levels of pain, physical functioning and ability to work. Poor physical performance capacity was associated with work-induced lumbar exertion. Interventions that aim to reduce fear-avoidance and increase fitness capacity might be beneficial