Reductions in Perceived Injustice are Associated with Reductions in Pain Catastrophizing in Individuals with Low Back Pain.

Abstract

Purpose: This study examined whether reductions in pain catastrophizing were associated with reductions in perceived injustice in individuals with occupational low back pain receiving physical therapy combined with a brief psychological intervention (Empowered Relief) to improve pain self-management skills.

Methods: A secondary analysis of a quasi-experimental study was conducted with 63 participants with subacute and chronic low back pain. Perceived injustice and pain catastrophizing were measured at baseline (T1) and four weeks post-intervention (T2). Correlation and regression analyses were performed to identify predictors of changes in perceived injustice. Ethical approval was obtained from the Université de Sherbrooke Research Ethics Board (#2022-3392).

Results: Changes in pain catastrophizing were strongly associated with changes in perceived injustice (r = 0.723, p < 0.001). Regression analyses revealed that pain stage and reductions in pain catastrophizing were significantly associated with decreases in perceived injustice. Regression analyses also revealed that reductions in the "rumination" subscale of pain catastrophizing significantly predicted changes in both subscales of perceived injustice.

Conclusion: The results demonstrate that reductions in pain catastrophizing are associated with reductions in perceived injustice during the subacute phase. The findings also shed light on shared mechanisms between pain catastrophizing and perceived injustice, emphasizing the role of rumination. The findings from this study underscore the importance of early psychological intervention for occupational low back pain, particularly in the subacute phase to improve recovery.