Low Back Pains Hidden Partners: Stigma, Anxiety, and Functional Decline in Adults with Cerebral Palsy

AIMDetermine biopsychosocial factors associated with pain interference and pain intensity in adults with cerebral palsy (CP) and chronic low back pain (LBP). METHODCross-sectional secondary data analysis of a community survey examining function and chronic pain in adults with CP and LBP. We examined bivariate relationships and built two regression models with pain interference with general activities and pain intensity as dependent variables and biopsychosocial factors as explanatory factors. RESULTSWe included 295 participants with CP and LBP in our analyses. Average age was 43.2 {+/-} 13.9 years, and 81% were ambulatory (GMFCS I-III). Pain was present for 17.9 {+/-} 13.4 years. Ordinary least squares regression models indicated greater pain interference with: change in best motor function since childhood (p=0.002), stigma (p=0.01), and anxiety (p=0.01; N=238; adjusted R2=0.17); and greater pain intensity with: lower income (p=0.01), Hispanic/Latino ethnicity (p=0.04), anxiety (p=0.01), and less satisfaction with social roles, (p<0.001; N=290, R2=0.18; Adjusted R2=0.16). INTERPRETATIONThese findings emphasize the importance of assessing and interpreting chronic pain in the context of biopsychosocial factors, particularly anxiety, stigma, race, ethnicity, income, satisfaction with social roles, and changes in motor function.