Front Pain Res (Lausanne). 2026 Jun 30;7:1872295. doi: 10.3389/fpain.2026.1872295. eCollection 2026.
ABSTRACT
INTRODUCTION: Psychoemotional Factors Are Closely Associated With Health-Related Quality Of Life (Hrqol) In Individuals With Chronic Low Back Pain (Clbp). However, It Remains Unclear Whether These Associations Differ Between Women And Men.
AIM: To Evaluate Sex-Stratified Associations Between Psychoemotional Factors And Hrqol Domains In Adults With Chronic Nonspecific Clbp.
MATERIAL AND METHODS: This Cross-Sectional Study Included 223 Adults With Chronic Nonspecific Clbp (138 Women And 85 Men) Assessed Before Initiation Of Outpatient Rehabilitation. Pain Intensity, Anxiety, Depression, Perceived Stress, Kinesiophobia, And Hrqol Were Evaluated Using Standardized Questionnaires. Primary Analyses Examined Associations Between Psychoemotional Thresholds And Eight Sf-36 Domains Separately In Women And Men. Secondary Analyses Assessed Severe Pain (Vas ≥7). Exploratory Logistic Regression Models With Sex-By-Variableinteraction Terms Were Additionally Performed. Multiple Testing Was Controlled Using The Benjamini-Hochberg False Discovery Rate Procedure.
RESULTS: The Prevalence Of Clinically Significant Anxiety, Depression, High Perceived Stress, And Kinesiophobia Did Not Differ Significantly Between Women And Men. In Sex-Stratified Analyses, Elevated Psychoemotional Burden In Women Was Primarily Associated With Lower Scores In Vitality, Mental Health, Social Functioning, And General Health. In Men, Associations Involved A Broader Range Of Hrqol Domains, Including Physical Functioning, Role Limitations, Bodily Pain, And General Health. In Secondary Analyses, High Kinesiophobia Was Associated With Severe Pain In Women (Or 9.00, 95% Ci 2.01-40.32; Q = 0.033), Whereas No Psychoemotional Indicator Remained Significantly Associated With Severe Pain In Men After Correction For Multiple Testing. However, Exploratory Sex-By-Variableinteraction Analyses Did Not Demonstrate Statistically Robust Interaction Effects After Adjustment For Potential Confounders And Correction For Multiple Testing.
CONCLUSIONS: Psychoemotional Factors Were Closely Associated With Hrqol In Adults With Chronic Nonspecific Clbp. Although Sex-Stratified Analyses Revealed Different Patterns Of Associations In Women And Men, Formal Interaction Analyses Did Not Provide Statistically Robust Evidence That These Associations Differed By Sex. The Findings Support The Importance Of Considering Psychoemotional Factors During Assessment And Rehabilitation Planning In Patients With Chronic Nonspecific Clbp And May Help Inform Future Individualized Rehabilitation Approaches.
PMID:42454245 | PMC:PMC13365172 | DOI:10.3389/fpain.2026.1872295
