Comparative Associations of Working Memory and Pain Catastrophizing With Chronic Low Back Pain Intensity.

Journal Article (Journal Article)

BACKGROUND: Because of its high global burden, determining biopsychosocial influences of chronic low back pain (CLBP) is a research priority. Psychological factors such as pain catastrophizing are well established. However, cognitive factors such as working memory warrant further investigation to be clinically useful. OBJECTIVE: The purpose of this study was to determine how working memory and pain catastrophizing are associated with CLBP measures of daily pain intensity and movement-evoked pain intensity. DESIGN: This study was a cross-sectional analysis of individuals with ≥3 months of CLBP (n=60) compared with pain-free controls (n=30). METHOD: Participants completed measures of working memory, pain catastrophizing, and daily pain intensity. Movement-evoked pain intensity was assessed using the Back Performance Scale. Outcome measures were compared between individuals with CLBP and those who were pain-free using nonparametric testing. Associations were determined using multivariate regression analyses. RESULTS: Participants with CLBP (mean age=47.7 years, 68% female) had lower working memory performance (P=.008) and higher pain catastrophizing (P<.001) compared with pain-free controls (mean age=47.6 years, 63% female). For individuals with CLBP, only working memory remained associated with daily pain intensity (R(2)=.07, standardized beta=-.308, P=.041) and movement-evoked pain intensity (R(2)=.14, standardized beta=-.502, P=.001) after accounting for age, sex, education, and interactions between pain catastrophizing and working memory. LIMITATIONS: The cross-sectional design prevented prospective analysis. Findings also are not indicative of overall working memory (eg, spatial) or cognitive performance. CONCLUSION: Working memory demonstrated the strongest association with daily pain and movement-evoked pain intensity compared with (and after accounting for) established CLBP factors. Future research will elucidate the prognostic value of working memory on prevention and recovery of CLBP.

Full Text

Duke Authors

Cited Authors

  • Simon, CB; Lentz, TA; Bishop, MD; Riley, JL; Fillingim, RB; George, SZ

Published Date

  • July 2016

Published In

Volume / Issue

  • 96 / 7

Start / End Page

  • 1049 - 1056

PubMed ID

  • 26700272

Pubmed Central ID

  • PMC4935786

Electronic International Standard Serial Number (EISSN)

  • 1538-6724

Digital Object Identifier (DOI)

  • 10.2522/ptj.20150335


  • eng

Conference Location

  • United States